AAOS 2026 reports mixed musculoskeletal findings for GLP-1 users

Research presented March 2, 2026, at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting in New Orleans found that GLP-1 receptor agonists, a drug class that includes semaglutide (Ozempic, Wegovy, Rybelsus), were linked to both benefits and risks for bone and joint health ^[1]. One study found fewer emergency room visits and infections after joint replacement surgery among GLP-1 users. A separate study found higher five-year rates of osteoporosis, gout and osteomalacia in people with Type 2 diabetes and obesity who took the drugs ^[1].

The first study looked at a national claims database covering patients with obesity-related diagnoses who had one of 10 common orthopaedic surgeries between 2010 and 2023, including hip and knee replacement, ACL repair, spinal fusion and shoulder replacement ^[1]. GLP-1 and semaglutide use rose sharply among these surgical patients starting in 2019 ^[1]. Across several major procedures, GLP-1 use was tied to significantly lower odds of postoperative ER visits, without a rise in surgical risk ^[1]. Among patients who had total knee or total hip replacement, GLP-1 users also had lower surgical site infection rates ^[1]. Revision surgery rates were lower for knee replacement patients on GLP-1 drugs, but higher among those who had carpal tunnel release ^[1].

The second study, led by a Michigan State University College of Human Medicine researcher, tracked patients with Type 2 diabetes and obesity (BMI of 30 or higher) using a large multi-institutional medical record database ^[1]. After matching 73,483 GLP-1 users to a comparable group of non-users based on age, sex, race, BMI, blood sugar control, smoking status and other health conditions, researchers found that after five years, GLP-1 users had a 4.1% rate of osteoporosis compared with 3.2% for non-users, a 29% higher relative risk ^[1]. Gout occurred in 7.4% of GLP-1 users versus 6.6% of non-users, a 12% higher relative risk ^[1]. The starkest difference was in osteomalacia, a bone-softening condition: 2% of GLP-1 users developed it compared with 0.1% of non-users, more than double the relative risk ^[1]. All three differences were statistically significant ^[1].

Why it matters for patients

These findings, presented as conference research rather than published peer-reviewed studies, point to a mixed picture for people on GLP-1 drugs who also face orthopaedic issues. For patients undergoing joint replacement, the data suggest GLP-1 use may be linked to a smoother short-term recovery, with fewer trips to the emergency room and lower infection rates after knee and hip surgery ^[1]. But the same drug class was associated with a higher long-term chance of developing osteoporosis, gout or osteomalacia over five years in a separate group of patients with diabetes and obesity ^[1]. Both studies were retrospective, meaning researchers looked back at existing medical records rather than running a controlled trial, so they show associations rather than proof that the drugs directly caused these outcomes.

The lead researcher on the bone health study said the results do not mean people should avoid the medications, but that clinicians should watch for these conditions in patients who are already prone to them, given how quickly GLP-1 use has spread ^[1]. He noted that five- and 10-year follow-up data on these drugs is only now becoming available, since large-scale use of GLP-1 medications for weight loss and diabetes accelerated after 2019 ^[1].

What happens next

Both studies were presented at the AAOS 2026 Annual Meeting on March 2, 2026, and have not yet been described by sources reviewed here as published in a peer-reviewed journal ^[1]. It is not yet known whether these findings will be confirmed in prospective studies or whether specific screening guidelines for bone health in GLP-1 users will follow.