GLP-1 receptor agonists and weight-loss strategies for individuals with obesity and hip or knee osteoarthritis: a scoping review
Conor McCann, Nick Clement, Andrew Murray, Ronan Kearney, Sharon Madigan, Christopher Gee, Phil Walmsley, Scott Morrison, Swati Chopra, Andrew HallObjective
To map current strategies for weight loss in hip and knee osteoarthritis (OA), with emphasis on the emerging role of glucagon-like peptide-1 receptor agonists (GLP-1-RAs) as tools in achieving weight loss and impacting symptoms, disease progression and perioperative outcomes in individuals with obesity.
Design
Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework and methodological guidance from the Joanna Briggs Institute and Arksey and O’Malley.
Data sources
PubMed, Web of Science, Directory of Open Access Journals, Scopus, ProQuest Central (1 January 2010 to 18 August 2025).
Eligibility criteria
Included studies focused on adults (≥18 years) with obesity and hip or knee OA, examined weight-loss strategies (nutritional, physical activity, surgical or pharmacological) including GLP-1-RAs.
Results
Of 199 included studies, 36 (18.1%) directly assessed GLP-1-RAs and of these, 14/36 (38.9%) reported original data. Evidence was heavily skewed towards knee OA, with limited hip-specific data. Descriptive analysis revealed a narrow geographical distribution of studies and a rapidly increasing focus on GLP-1-RAs; most studies involving GLP-1-RAs (29/36, 80.6%) were published between 2024 and 2025 and were of a low level of evidence (19/36, 52.8% level 5). Randomised and cohort data in knee OA indicate that GLP-1-RAs are associated with substantial weight loss, with accompanying improvements in pain/function and reduced progression to arthroplasty. In contrast, evidence in hip OA is sparse with weaker associations.
Conclusion
GLP-1-RAs represent a promising adjunct for managing individuals with OA complicated by obesity. Until further evidence emerges, GLP-1-RAs should be integrated into supervised, multimodal musculoskeletal care rather than used as standalone weight-loss agents.