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Sponsor: The University of Hong Kong
Conditions: Osteoarthritis (OA) of the Knee
Interventions: Glucagon-like peptide-1 receptor agonists (GLP 1 RA), Control (Standard treatment)
Countries: Hong Kong
Studies have shown that obese patients undergoing total knee replacement (TKR) surgery face a higher risk of perioperative issues such as increased use of pain medication, surgical site infections, and the need for revision surgeries compared to non-obese patients. Obesity is also linked to more significant preoperative pain and lingering symptoms post-surgery. Consequently, there's a growing interest in weight loss interventions prior to TKR to enhance perioperative care and outcomes. Recent retrospective studies have indicated that such interventions can improve physical function post-TKR. Research focusing on weight loss interventions before joint replacement surgery is limited. There is currently a gap in research regarding RCTs on weight loss interventions using anti-obesity drugs before TKR, particularly in Asian populations. One promising avenue under exploration involves the use of glucagon-like peptide 1 receptor agonists (GLP-1RAs) as anti-obesity medication before total knee replacement (TKR) surgery. However, there are currently no randomized controlled trials (RCTs) examining the effects of GLP-1RAs on knee arthroplasty outcomes. Large database studies have indicated that GLP-1RAs may decrease the likelihood of certain post-surgery complications but increase the risk of others. In summary, addressing obesity through weight loss interventions, particularly with GLP-1RAs, holds promise for improving outcomes in TKR patients. However, further research, including randomized controlled trials, is necessary to fully understand the effects of GLP-1RAs on perioperative outcomes and patient health.
Sex: ALL
Age: 40 Years to 80 Years
Healthy volunteers: No
Study type: INTERVENTIONAL
Inclusion Criteria: * Age between 40 and 80 years old * BMI ≥27 kg/m2 * On the surgical waiting list for primary TKR * Willing and able to cooperate in a weight management programme. * Meeting indication for semaglutide Exclusion Criteria: * Revision surgery or surgery for neoplastic disease * A medical condition which in the opinion of the investigators makes the patient unsuitable for participation in the trial * Contraindication to GLP-1RA, like history of pancreatitis, severe gastrointestinal diseases such as gastroparesis, thyroid cancer, and inflammatory bowel disease * Lack of acceptance of the randomisation process.
- Hong Kong, Pokfulam, Hong Kong