Postoperative outcomes after total knee arthroplasty in type 2 diabetes mellitus patients receiving semaglutide versus tirzepatide: a propensity score-matched national research network analysis
- Design
- Retrospective cohort · 830 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different population[Auto] Participants had type 2 diabetes (age/BMI not reported in abstract).
- Could weight loss explain it?
- Possibly[Auto] Participants had obesity and/or type 2 diabetes and the abstract does not separate direct drug effects from weight loss or glycaemic improvement.
- Study tier
- Study tier 3[Auto] Observational design; confounding by indication and healthy-user effects cannot be excluded (auto-provisional).
- Assessment
- Version 1 · automatic, not yet reviewed by a person · Sep 13, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
[Auto, unreviewed; quoted from abstract conclusions] In a large, propensity-matched national cohort of primary TKA, semaglutide and tirzepatide demonstrated similar short-term safety and utilization profiles. These findings support continued perioperative use of either agent in T2DM patients undergoing TKA.
01Findings
What the study reported
- Drugs
- Semaglutide, Tirzepatide
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- Not stated
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Diabetes status
- type 2 diabetes present (all or most)
- Cvd status
- cardiovascular disease present in population (see abstract)
- Sample size
- 830
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 830
- Randomization
- no
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- not stated
- Outcome type
- hard
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- CI reported: 95% confidence intervals (CIs
- Risk of bias
- not assessed (auto)
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[BACKGROUND] Semaglutide (GLP-1 receptor agonist) and tirzepatide (dual GIP/GLP-1 agonist) are increasingly prescribed to adults with type 2 diabetes mellitus (T2DM) undergoing total knee arthroplasty (TKA). Whether short-term postoperative outcomes differ between these agents was unknown. [METHODS] This was a retrospective cohort study using the TriNetX research network database. Adults with T2DM who underwent primary TKA between June 1, 2022, and December 31, 2024, and had an active prescription for semaglutide or tirzepatide within 90 days preoperatively were eligible. 1:1 propensity score matching was conducted on age, sex, race, body mass index, hemoglobin A1c, comorbidity burden, and concurrent diabetes medication use, yielding 415 matched pairs. Outcomes through 90 and 180 days included medical complications, surgical complications, and healthcare utilization. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression. [RESULTS] After matching (n = 830), there were no differences in 90-day medical complications (OR 1.122, 95% CI 0.736-1.710; P = 0.591) or 180-day surgical complications (OR 1.632, 95% CI 0.845-3.152; P = 0.141) between semaglutide and tirzepatide cohorts. Individual events, including myocardial infarction, stroke, pneumonia, sepsis, pulmonary embolism, deep vein thrombosis, acute kidney injury (OR 0.867, 95% CI 0.417-1.801; P = 0.701), urinary tract infection (OR 1.562, 95% CI 0.863-2.827; P = 0.138), surgical site infection (OR 1.726, 95% CI 0.782-3.810; P = 0.172), periprosthetic joint infection, wound dehiscence, mortality, and revision-were statistically similar (all P > 0.05). Emergency department visits and/or readmissions were comparable at 90 days (OR 0.775, 95% CI 0.570-1.052; P = 0.102) and 180 days (OR 0.887, 95% CI 0.672-1.170; P = 0.397). Several outcomes had low event counts in both groups, limiting precision. [CONCLUSION] In a large, propensity-matched national cohort of primary TKA, semaglutide and tirzepatide demonstrated similar short-term safety and utilization profiles. These findings support continued perioperative use of either agent in T2DM patients undergoing TKA.