ArticleAnnals of the Royal College of Surgeons of England2026
Potential underutilisation of weight loss medications in obese patients with knee osteoarthritis.
Article in Annals of the Royal College of Surgeons of England, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionObesity is a major risk factor for knee osteoarthritis (OA), contributing to earlier symptomatic onset, increased pain severity and greater lifetime disability. Despite guidance that weight alone should not limit access to total knee arthroplasty (TKA), body mass index (BMI) thresholds are applied widely in clinical practice. This study investigated the glucagon-like peptide-1 (GLP-1) receptor agonist (RA) use among obese OA patients awaiting TKA and evaluated the influence of BMI on access to TKA.
methodsA 30% random sample of a single-centre TKA waiting list (
resultsMedian BMI was 33.0 [27.9-38.0], with 120 patients (40%) classified as obese (BMI ≥35). Among obese patients, 45% were initially denied or conditionally listed for surgery, rising to 74.1% for BMI >40. Only 13 obese patients (10.8%) were taking GLP-1 RAs, despite extensive eligibility. Female patients had a higher average BMI (
conclusionCurrent pathways for managing obese patients with knee OA are inadequate. GLP-1 RAs may offer a promising solution to help reduce barriers to surgery. Further research is needed to determine whether GLP-1 RAs could help reduce the progression of OA and need for TKA.
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