ArticleBone & joint open2026
Protocol for Novel Perioperative Optimization of Obese Osteoarthritic Patients pending Total Knee Replacement with glucagon-like peptide-1 receptor agonist (NPO-OOPS-TKR) : a pilot randomized controlled trial.
Article in Bone & joint open, 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
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Abstract
Aims: Obesity is associated with higher rates of perioperative complications and worse pain and functional outcomes after total knee arthroplasty (TKA). Preoperative optimization through weight management is therefore clinically appealing, but the current evidence base is mixed. No randomized controlled trial (RCT) has evaluated glucagon-like peptide-1 receptor agonists (GLP-1RAs) as a perioperative optimization strategy before TKA, and no such trial has focused on an Asian population. This pilot randomized trial therefore aims to determine the feasibility, tolerability, and acceptability of semaglutide-based optimization before and after TKA in older Asian adults with obesity. Methods: This is a two-arm pilot RCT that will recruit 54 adults aged 40 to 80 years with obesity (BMI ≥ 27 kg/m Conclusion: This pilot trial will determine whether a definitive randomized trial is feasible in older Asian adults with obesity awaiting TKA. The study is designed to estimate recruitment, adherence, tolerability, and retention, and to generate preliminary effect-size estimates for a future fully powered trial. Because semaglutide may influence perioperative outcomes through mechanisms beyond weight loss alone, including metabolic and anti-inflammatory pathways, these pathways will be considered when interpreting the findings.
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