Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for obesity and type 2 diabetes mellitus (T2DM). While their metabolic benefits are well-established, their impact on postoperative outcomes following total joint arthroplasty (TJA) remains controversial. This study aimed to systematically evaluate the association between GLP-1 RA use and postoperative outcomes in patients undergoing total hip (THA), knee (TKA), or shoulder arthroplasty (TSA). Methods: We conducted a PRISMA-compliant systematic review and meta-analysis across PubMed, Embase, Web of Science, and Scopus through April 24, 2025. Eligible retrospective cohort studies compared adults undergoing TJA with and without preoperative GLP-1 RA exposure. Primary outcomes were 90-day readmission and all-cause revision. Pooled odds ratios (ORs) and standardized mean differences (SMDs) were calculated under random-effects models. Subgroup analysis based on the type of arthroplasty was conducted where applicable. Results: Fourteen studies (total sample size of 365,154; including 62,117 (17.01%) GLP-1 consumers, and 303,037 (82.98%) control cases) met the inclusion criteria (All studies included primary TJA cases). GLP-1 RA use was associated with lower 90-day readmission (OR = 0.86, 95% CI: 0.74-0.99, p = 0.033) and reduced sepsis incidence (OR = 0.63, 95% CI: 0.46–0.88, p = 0.006). No significant differences were observed for all-cause revision, thromboembolic events, and other medical and surgical complications. Length of stay was marginally shorter in GLP-1 users (SMD = −0.09, p = 0.048). Subgroup analyses showed the strongest sepsis reduction in TSA. Conclusion: GLP-1 RA use before TJA is associated with reduced readmission and sepsis risk without increasing surgical or thromboembolic complications. These findings support the potential perioperative benefits of GLP-1 RAs, warranting prospective trials to confirm causality and define optimal perioperative strategies for high-risk arthroplasty patients.

Background: Comparisons of outcomes after transcatheter aortic valve replacement with balloon‐expandable (BEV) versus self‐expanding (SEV) valves are limited.Hypothesis: This study aimed to compare clinical and hemodynamic outcomes of BEV and SEV at short‐term (30 days), midterm (1 year), and long‐term (> 1 year) endpoints.Methods: PubMed, Embase, Scopus, and Cochrane Library databases were searched until July 2024 for randomized controlled trials. Random‐effect model (DerSimonian–Laird method) was used to pool the risk ratios (RR), mean differences, and 95% confidence intervals (CI).Results: A total of 10 studies comprising 4325 patients (2295 BEV, 2030 SEV) were included. In short‐term, cardiovascular (RR: 0.56, 95% CI: 0.36–0.87) and all‐cause mortality (RR: 0.54, 95% CI: 0.35–0.81) were lower in the BEV group. Risk of moderate to severe paravalvular leak (PVL) was lower among BEV patients in short‐term (RR: 0.28, 95% CI: 0.17–0.49) and long‐term (RR: 0.28, 95% CI: 0.1–0.79). A limited number of studies showed a greater risk of clinical valve thrombosis on BEV in midterm and long‐term. The need for permanent pacemaker implantation was lower in BEV at both short‐term (RR: 0.56, 95% CI: 0.37–0.87), and midterm (RR: 0.78, 95% CI: 0.64–0.94). The SEV group had a larger effective orifice area with lower mean transvalvular pressure gradient at all endpoints.Conclusions: BEV is associated with reduced risk of clinical outcomes in short‐term; however, most differences diminish in longer evaluations, except for moderate to severe PVL, which remains elevated for SEV. SEVs had better hemodynamic results and lower risk of clinical valve thrombosis.

Background: Hypertension, a leading global risk factor for mortality and disability, disproportionately affects racial and ethnic minorities. Our study investigates the association between the type of prior antihypertensive medication use and the likelihood of cardiovascular events (CVE) and assesses whether the patient's race influences this relationship.Methods: A retrospective study of 14 836 hypertension cases aged ≥ 40 years was conducted using data from HCA Healthcare between 2017 and 2023. Logistic regression was employed to predict the likelihood of CVE and mortality at admission, adjusting for baseline comorbidities, with Race added as an effect modifier. Interaction analysis was performed among races based on antihypertensive medication types.Results: African American patients on ACE inhibitors (ACE) or angiotensin receptor blockers (ARBs) were 1.7 times more likely to have cardiovascular events (CVE) compared to those on calcium channel blockers (CCBs) and 0.66 times as likely compared to diuretics. CCB users had a lower CVE risk than diuretic users. Among White patients, ACE/ARB users had a 1.18 times higher CVE risk than CCB users and 0.45 times lower compared to diuretics, while CCBs offered a 0.38 times lower risk than diuretics. Only ACE/ARB use showed significantly higher CVE odds for African Americans compared to White patients, with similar risks across racial groups for CCBs and diuretics.Conclusion: Prior antihypertensive type significantly influenced CVE risk, with race as an effect modifier. CCB users had lower CVE odds than ACE/ARBs or diuretics, and ACE/ARBs showed reduced CVE likelihood compared to diuretics in both racial groups.

The management of pathologic fractures (PF) following osteomyelitis (especially the acute subtype) has not been widely investigated. Therefore, this study aims to assess a stepwise treatment plan for the acute incidence of PF in long bones following pediatric acute Hematogenous osteomyelitis (AHO). This case series was conducted between 2011 and 2023 in a tertiary pediatric center. Patients with fracture incidence within the first 10 days after AHO diagnosis were included. Patients’ characteristics were retrospectively reviewed. Our stepwise treatment plan was as follows: Eight patients (6 boys) with a mean age of 32.1 ± 26.7 months and a follow-up time of 8.64 ± 1.95 years were included. The etiology in all patients was hematological Methicillin-resistant Staphylococcus aureus. Except for one patient who died of septic shock, all other patients (87.5%) reached complete recovery (average length of hospital stay of 19.9 days) and obtained union with an average union time of 14.6 months. A mean of 1.25 surgical procedures, ranging from 0 to 4, were required to obtain union. The outcome of the stepwise plan in this study suggests that acute PF following AHO in pediatrics can be managed effectively with favorable clinical and functional outcomes in the mid- and long-term.

Background: Inflammatory Bowel Disease (IBD) is associated with systemic inflammation and which might influence surgical outcomes. As total joint arthroplasty (TJA) becomes increasingly common in this population as they age, this study aimed to evaluate whether IBD is associated with increased postoperative complications following total hip or knee arthroplasty. Methods: We performed a systematic review of studies including patients with and without IBD undergoing TJA. Databases searched included PubMed, Scopus, Web of Science, and Embase through February 24, 2025. Eligible studies included adults with a confirmed diagnosis of IBD who underwent TJA. Meta-analyses were conducted using random-effects models with 95% confidence intervals. Results: Fourteen studies comprising 2,651,318 patients (86,581 with IBD) met inclusion criteria. IBD was significantly associated with increased risks of PJI (OR: 1.47), hospital readmission (OR: 1.39), pneumonia (OR: 1.92), PTE (OR: 1.61), VTE (OR: 1.59), DVT (OR: 1.60), ileus (OR: 5.7), C. difficile infection (OR: 3.3), MI (OR: 2.12), CVA (OR: 2.90), UTI (OR: 2.31), sepsis (OR: 1.83), respiratory failure (OR: 2.17), revision surgery (OR: 1.38), periprosthetic fracture (OR: 1.82), wound (OR: 1.52) and implant complications (OR: 1.62). Length of hospital stay was marginally longer (SMD: 0.06). Mortality and non-home discharge did not differ significantly between groups. Conclusion: Patients with IBD undergoing TJA are at an elevated risk for some postoperative complications, especially infections, thromboembolic events, and revision surgeries. These findings support personalized management strategies in this population. Level of Evidence: Level IIIa. See Instructions for Authors for a complete description of levels of evidence.