Not clearly. Three database cohorts disagree. In type 2 diabetes, users had fewer trigger finger diagnoses but more release operations [2]. After a steroid injection, users went on to surgery slightly less often, 10.6% against 11.9% at a year [1]. After a release, users had more pain at a year, 21.6% against 16.9%, and more repeat surgery, 11.4% against 9.5% [3]. The foot complications of diabetes are covered separately in GLP-1 drugs and diabetic neuropathy.
What trigger finger is
A thickened tendon catches as it slides through a pulley in the palm. It is more common in people with type 2 diabetes [1].
The first treatment is a steroid injection. When that fails, surgery releases the pulley. The operation is called an A1 pulley release.
Fewer diagnoses, more operations
One cohort compared adults with type 2 diabetes with and without a GLP-1 history [2]. Users had a significantly lower prevalence of trigger finger.
The same study found a higher prevalence of release surgery among users. The authors call that finding interesting and do not explain it. Its abstract reports the directions without the rates.
Complications within 90 days of release were similar in both groups. That covered surgical site infection, joint stiffness, wound breakdown, and abscess drainage.
Surgery after a steroid injection
A second cohort took adults with type 2 diabetes who had already had a steroid injection [1]. Matching left 5,863 per group.
At six months there was no significant difference, 6.1% against 6.8%. At twelve months, 10.6% of users had gone on to release against 11.9%, a relative risk of 0.89, 95% CI 0.81 to 0.99. At 24 months it was 14.2% against 15.7%.
The authors convert that to a number needed to treat of 71 at a year and 59 at two years. The twelve-month interval runs to 0.99. The unit itself is explained in the cardiovascular number needed to treat.
Outcomes after the operation
A third cohort took everyone having a trigger finger release [3]. It matched 4,283 GLP-1 users with 4,283 non-users on metabolic risk and other conditions.
Users fared worse on four measures. At a year, pain ran 21.6% against 16.9%. Scarring ran 2.3% against 1.5%. Wound complications ran 2.3% against 1.4%.
Repeat release was higher at one year only, 11.4% against 9.5%. Infection, systemic complications and health care use did not differ.
The authors suggest a possible long-term effect on tendon or wound healing. They call for further study. Healing after other operations is covered in whether GLP-1 drugs slow wound healing.
Where the studies disagree
On surgery, one cohort found fewer operations after a steroid shot. Another found more operations overall.
On complications, one found no difference at 90 days. Another found more wound problems at 90 days and a year. The two used different populations and different exposure windows.
All three used the same US research network. None randomized anyone. A filled prescription marks who chose the drug, which is the limit shared by the other surgical outcome studies.
What this means before hand surgery
No one should start a GLP-1 to avoid trigger finger surgery. The evidence does not support it.
Anyone already on one and facing a release has a question for the surgeon. The general rules on holding these drugs before an operation are in whether you have to stop a GLP-1 before surgery.