Kisiel, Sara C.

Background In 2019, the “Facts on Hand” direct-to-consumer advertising (DTCA) campaign, featuring former NFL quarterback John Elway, was launched to raise awareness of Dupuytren's contracture (DC) and its nonsurgical treatment options. Although DTCA has been shown to influence health care behavior in other specialties, its impact on treatment patterns for hand conditions remains unclear. Methods Google Trends was used to examine the influence of direct-to-consumer advertising (DTCA) on Internet-based information-seeking behavior related to DC. Changes in the proportion of surgical and nonsurgical management of DC were evaluated using 2016–2021 Medicare provider billing claims. Results Search interest in DC peaked during the campaign period, with breakout-level increases (>5000%) for terms such as “John Elway,” “needle aponeurotomy,” and “hand surgeon near me.” Medicare data revealed regionally significant increases in CCH utilization, particularly in the Midwest (+10%) and Northeast (+5%), with corresponding declines in fasciectomy. Regional overlap between increased search activity and shifts in treatment patterns suggests a geographically reinforced campaign effect. Conclusion The “Facts on Hand” campaign was associated with increased public interest in DC and coincided with regionally specific shifts in treatment utilization. Although the campaign emphasized a nonsurgical option, breakout searches for terms such as “hand surgeon near me” and “Dupuytren's surgery” suggest that treatment-specific advertising may have encouraged broader engagement with treatment overall. These findings highlight the potential for DTCA to not only raise awareness of the condition itself but also prompt patients to seek specialist care.

Abstract Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for weight management and cardiometabolic health. Common peroneal neuropathy (CPN) associated with rapid weight loss is attributed to adipose tissue reduction and subsequent nerve compression at the fibular head. Cases of “Slimmer’s Palsy” have been described in conditions involving rapid weight loss, including anorexia, malignancy, and post-biliary surgery, yet it remains underrecognized as a potential complication of GLP-1RA therapy. This case report describes two nondiabetic patients who developed acute foot drop after losing 14% and 18% of their total body weight over 3–6 months of semaglutide and tirzepatide use, respectively. As use of GLP-1RAs continues to rise, peripheral nerve surgeons should be aware of Slimmer's Palsy as a predictable and treatable complication of rapid weight loss and be prepared to intervene before permanent denervation occurs.

Background: Diabetic patients experience carpal tunnel syndrome (CTS) at high rates, have increased symptom severity, and experience prolonged recovery after carpal tunnel release (CTR). This study assessed the association of glucagon-like peptide-1 receptor agonist (GLP-1) therapy with postoperative outcomes after CTR in type II diabetic patients with CTS. Methods: Using the PearlDiver database, 25 229 diabetic patients with CTS who underwent CTR and were prescribed GLP-1 therapy were identified and exact matched to 25 229 controls based on age, sex, Elixhauser comorbidity index, tobacco use, obesity, hypothyroidism, and body mass index where available. Demographic variables and comorbidities were compared between groups using Kruskal-Wallis analyses for continuous variables and chi-square tests for categorical variables. Bivariate logistic regression analysis was conducted for 90-day outcomes and 2-year CTR revision. Results: Patients on GLP-1 therapy had decreased risk of 90-day medical complications (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.84-0.96) and hospital readmission (OR = 0.85; 95% CI, 0.77-0.94) of 0.5% and 0.4%, respectively, compared with controls. No significant differences were found in 90-day surgical complications or 2-year revision rates between cohorts. There were no cases of aspiration pneumonia. The GLP-1 cohort had increased odds of higher 90-day total costs of care (OR = 2.42; 95% CI, 1.88-3.15). Conclusions: GLP-1 therapy is associated with reduced risk of 90-day medical complications and hospital readmission following CTR in diabetic patients, suggesting these medications may optimize comorbidity profiles via glucose control preoperatively. Future studies may examine whether GLP-1 therapy is associated with minimum clinically important difference in patient-reported outcome measures for CTS in diabetic patients.

Glucagon-like peptide-1 (GLP-1) receptor agonists are medications used to treat type 2 diabetes and may aid in weight loss efforts. The surgical management of patients taking GLP-1 agonists differs from others due to the slowed gastric emptying effects of GLP-1 medications. Patients taking these medications may have a higher risk of pulmonary aspiration during hand surgery than other patients, which affects their presurgical management. This article reviews GLP-1 agonists and their role in diabetes and weight loss, as well as current recommendations for surgical management of patients taking GLP-1 agonists.