PREOPERATIVE TIRZEPATIDE THERAPY IN OBESE TOTAL HIP ARTHROPLASTY CANDIDATES: A MODELLING STUDY OF COST AND COMPLICATION REDUCTION

Obesity is a well-established risk factor for complications following total hip arthroplasty (THA), yet achieving significant pre-operative weight reduction through lifestyle modification alone remains challenging. This study modelled the potential clinical and economic implications of pre-operative Tirzepatide therapy in obese THA candidates. Complication rates and associated costs were derived from published datasets, including 891,567 THA procedures stratified by body mass index (BMI). Venous thromboembolism (VTE) and all-cause revision surgery were included as primary outcomes. Weight reduction data from the SURMOUNT-5 trial were applied to each BMI category to generate adjusted complication and cost profiles. The model demonstrated a progressive increase in mean complication cost from £900 per patient (BMI 20–29 kg/m 2 ) to £2,639 per patient (BMI ≥50 kg/m 2 ). Simulated Tirzepatide-associated weight loss was projected to yield mean savings of £437, £538, and £717 per patient within the BMI 30–39, 40–49, and ≥50 kg/m 2 groups, respectively, primarily through reductions in VTE and revision rates. Pre-operative Tirzepatide therapy may therefore offer a cost-effective means of optimising obese patients prior to THA, with potential to reduce peri-operative complications and improve surgical access among previously ineligible candidates. Prospective clinical studies are required to confirm these theoretical findings.