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Future trials should therefore include body-composition assessment, muscle strength testing, physical performance measures, and rehabilitation adherence as core outcomes, rather than focusing only on body weight and pain ( 7.3 Perioperative management before arthroplasty Although current perioperative guidance emphasizes individualized assessment of GLP-1 receptor agonist use, KOA-specific perioperative pathways have not yet been established ( 7.4 Structural disease modification remains unproven in humans Perhaps the most important scientific limitation is that symptomatic improvement should not yet be interpreted as proof of structural disease modification
