GLP-1 medications such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have changed how many people manage diabetes and weight. I now see them on medication lists every week, and patients ask good questions. Do they help my knee? Do they change my surgery? Should I stop them?
Weight and arthritis
Extra weight increases the load on your knees with every step. The American Academy of Orthopaedic Surgeons recommends sustained weight loss for people with knee arthritis who are overweight.1 For some patients, losing weight eases pain enough to delay surgery. For others, it makes surgery safer and recovery easier.
What the early research shows
- Lower infection risk in some patients. In a large database study of patients with diabetes, those taking a GLP-1 medication had a lower rate of joint infection in the year after knee replacement: 1.21% compared with 2.04%. There was no significant difference after hip replacement.2
- Possibly more benefit at higher weights. A study presented at the 2026 AAOS Annual Meeting found that semaglutide use was linked to lower two-year infection and revision rates after knee replacement in patients with a BMI of 40 or above, but not in patients with a BMI under 30.3
These are observational studies. They show associations, not proof that the medication caused the difference, and researchers are still studying bone health and muscle loss with rapid weight loss. They are encouraging, but they're not a reason to start a medication just for surgery.
What to tell your surgical team
- Always list your GLP-1 medication, including the dose and what day you take it. These drugs slow stomach emptying, which matters for anesthesia. Your team will tell you whether and when to pause it before surgery. Don't stop or change it on your own.
- Protect your protein and strength. Fast weight loss can cost muscle, and strong muscles help you recover. Ask about a protein target and prehab exercises.
- Talk about timing. If you're actively losing weight, we may plan surgery around a target that makes the operation safer.
The bottom line
GLP-1 medications can be a helpful tool on the road to a healthy joint replacement, and the early data is promising. The key is coordination between you, your prescribing doctor and your surgical team. Request a consultation and bring your medication list.
- American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Non-Arthroplasty): Evidence-Based Clinical Practice Guideline, 3rd ed. 2021.
- Levidy MF, et al. The effects of glucagon-like peptide-1 agonist therapy on risk of periprosthetic joint infection following total joint arthroplasty. J Am Acad Orthop Surg. 2025;33(21):1213–1218.
- Xu J, Magruder ML, et al. Semaglutide use and outcomes after total knee arthroplasty by body mass index. Presented at the AAOS Annual Meeting, 2026.
This article is for general education and is not medical advice. Talk with your surgeon about your own situation.