GLP-1s and Joint Health: What You Need to Know Before Surgery

Understanding the "New" GLP-1 Trend

Everyone has been talking about the new weight loss shots like Ozempic, Wegovy, and Mounjaro. These medications, known as GLP-1 receptor agonists, are everywhere in 2026. While they were first made to treat diabetes, they are now widely used for weight management.

If you are planning to have a knee or hip replacement, you probably have a lot of questions. Are these drugs safe for your health? Is it safe to stay on these drugs before surgery? How do they affect your recovery? Can they actually help you get a better result from your new joint?

At Mellano Orthopedics, we look at your whole body, not just your bones, to make sure you are ready for a successful procedure. Recent data from the 2025 and 2026 American Academy of Orthopaedic Surgeons (AAOS) shows that these medications are changing the game for orthopedic patients. They are helping people who used to be considered high-risk become ideal candidates for surgery.

Why Weight Loss Makes Surgery Safer

For a long time, many patients with joint pain were stuck in a difficult cycle. They were told they needed to lose weight before they could have a joint replacement because their excess weight made the surgery too risky. However, it is very hard to lose weight when your knees or hips hurt so much that you can't walk.

This is where these injectable prescription medicines are making a huge difference. By helping patients reach a healthier weight before their operation, they are optimizing BMI for surgical success.

There is a simple reason for this: for every pound you lose, you take four pounds of pressure off your knees. When you show up for surgery at a lower weight, your body is under less stress. This leads to several major benefits:

• Lower Risk of Infection: Data shows that patients who use GLP-1s to reach a healthier weight have a much lower chance of a serious infection or a prosthetic joint infection after surgery.
• Easier Recovery: It is much easier for your healthcare provider to get you up and moving the same day as your surgery if your body is carrying less weight.
• Longer-Lasting Joints: Less weight means less wear and tear on your new titanium joint, helping it last for decades.

It’s Not Just Weight, It’s Also About Inflammation

Doctors are finding that GLP-1s do more than just help you drop pounds. They actually work on your endocrine system condition to calm down inflammation throughout your whole body.

We used to think that arthritis was just wear and tear. We now know that it is also a metabolic problem. When your body is in a constant state of inflammation, it can degrade your cartilage faster. Some patients find that their joints feel better, meaning less severe pain and fewer flare-ups, even before they lose a significant amount of weight.

By calming this internal heat before surgery, your tissue is often healthier and ready to heal faster once the procedure is over. This is especially helpful for patients in the South Bay who want to get back to an active lifestyle as quickly as possible.

Protecting Your Muscle Engine

While losing weight is great for your joints, we have to be careful about how we lose it. When people lose weight very quickly on these medications, they can sometimes lose muscle mass along with fat.

In orthopedics, we think of your muscles as the engine that moves your new joint. If your engine is weak, it’s hard to rehab your new knee or hip. To prevent mood changes or feeling weak, we work with our patients on a Muscle-Sparing plan:

• Prioritize Protein: It is very important to eat enough protein to give your muscles the fuel they need.
• Strength Training: We recommend simple resistance exercises, like using bands or light weights, to keep your engine strong while the weight comes off.
• Drink Fluids: Staying hydrated helps prevent stomach problems and keeps your muscles functioning well.

If you start feeling jittery or notice dehydration leading to fatigue, it’s a sign your body needs more support. Our goal is for you to arrive at surgery lighter, but also stronger.

The Most Important Rule: The 14-Day Pause

If you are scheduled to have surgery, the biggest question is: Can I take my shot the week of my procedure? The answer is a very important no.

These medications work by slowing down how fast your body is digesting food. This means food stays in your stomach much longer than normal. If you have food in your stomach when you go under anesthesia or deep sleepiness, it can be very dangerous. You could accidentally breathe food into your lungs during surgery, which can cause a serious condition called aspiration pneumonia.

To keep you safe, the newest medical guidelines for 2026 require you to stop your weekly GLP-1 shots at least 14 days before any procedures that use anesthesia. This includes deep sedation and anesthesia or deep sleepiness.

Managing Side Effects and Safety

Like any prescription medication, GLP-1s can have side effects. Most people experience the most common side effects, which are usually stomach problems like an upset stomach or nausea. However, there are some things you should always report to your healthcare provider:

• Severe Problems: If you have severe pain in your upper stomach area, it could be a sign of gallbladder problems or pancreatitis.
• Vision Changes: Some patients with adults with type 2 diabetes may notice blurred vision or diabetic retinopathy getting worse.
• Kidney Health: If you have a history of kidney disease or kidney problems, we need to monitor you closely to prevent kidney failure or the kidney disease worsening.
• Allergic Reactions: While rare, serious allergic reactions or a severe rash should be treated as a medical emergency.

Always tell your surgical team about all the medicines you are taking, including over-the-counter medicines, herbal supplements, and other prescription drugs. This helps us prevent any bad reactions during your care.

Your 6-Month Pathway to a New Joint

We don't just focus on the hour you spend in the operating room. We look at the months leading up to it as a pathway to success. Here is how we typically structure this journey:

1. Preparation (Months 1-4): You work with your primary doctor to use GLP-1s to improve blood sugar and lose weight. During this time, you follow a reduced-calorie diet but stay focused on keeping your muscles strong.
2. Optimization (Month 5): We check your progress. We make sure your weight is stable and you aren't having severe problems like problems breathing or slurred speech.
3. The Pause (2 Weeks Before): You stop your medication to ensure your stomach is empty for surgery.
4. Surgery Day: Dr. Mellano performs your minimally invasive joint replacement. Because you are lighter and stronger, you are usually back on your feet and heading home the same day.
5. Recovery (Month 6+): You return to the activities you love, with less pain and a healthier heart.

Moving Toward a Healthier Future

Joint surgery includes looking at your medical conditions and your weight management as part of your overall joint health. These new medications are helping us provide better, safer care for patients with weight-related medical problems. If you have been told in the past that you aren't a candidate for surgery because of your weight, it might be time for a second opinion.