Orthopedic Surgery

SGLT2 inhibitors linked to lower 10‑year TJR and knee OA outcomes versus GLP‑1 RA and DPP‑4i

In a large retrospective new‑user cohort, second‑line SGLT2 inhibitor use was associated with lower observed 10‑year TJR risk than GLP‑1 RA (0.505% vs 0.674%) in propensity‑matched analyses. SGLT2i versus DPP‑4i showed 0.483% vs 0.891% 10‑year TJR risk, with hazard ratios favoring SGLT2i versus GLP‑1 RA (HR 0.85, 95% CI 0.73–1.00). Associations were stronger for knee‑related OA diagnoses and injections than for hip outcomes. This is observational data from electronic health records with propensity matching; residual confounding and indication bias remain possible. 1

Randomised ORAKTx: robot‑assisted kidney transplant showed fewer early complications but not statistically significant

In a single‑centre RCT of 107 transplanted adults, major surgical complications occurred in 25% with open versus 13% with robotic surgery (risk difference −11%, p = 0.2). Vascular complications were 19% open versus 9.4% robotic (risk difference −9.4%, p = 0.3). Magnitude favors robotics for reducing early surgical morbidity but the trial was underpowered and unblinded. Larger multicentre studies are needed before changing standard operative approach broadly. 2

CROP checklist: 29‑item Delphi consensus tool to improve process‑evaluation reporting

A five‑round international Delphi produced the CROP checklist with 29 items achieving consensus for healthcare‑wide process evaluations. Content validity improved across rounds with face validity >0.80 and high expert agreement on relevance and clarity. CROP aims to standardize reporting to improve reproducibility and implementation interpretation of complex interventions. Adoption by journals and trialists will determine practical impact on study transparency. 3