Knee replacement

[barbthy]

My orthopedic surgeon says my left knee is bone on bone and needs replacement. I had right knee replaced in 2008 - pre PMR - and it did well, of course I was 11 years younger. My question is I am presently on 7.5 - 6.5 mg prednisone and am ready to go to 7 - 6 mg. Surgery is scheduled for 4/16. Should I follow my decreasing schedule or stay where I am until after surgery. Looking for your expert advice.

Thanks,

Barbara

[DorsetLady PMRGCAuk volunteer]

Unless your surgeon has any objections I would say - stay where you are until after surgery. But you do need to discuss with him.

[suzy1959]

I have just had my second joint replacement, both times I was on 11 mgs Pred. The anaesthetist gave me a steroid infusion after the ops, whilst I didn’t change my oral dose. This worked and I didn’t flare. Your body is going through quite a brutal trauma, so my advice is not to reduce before or afterwards for quite a while until your body has had time to recover.

[Birdboxinthegarden in reply to suzy1959]

I have bone on bone both knees. One knee was very very swollen. However since taking Pred the swelling has reduced dramatically as has the awful pain.I saw the Orthpeadic Consultant on Thursday last and he explained that when I stop the steroids I will get the reverse back. A few of my friends advised me beforehand to give serious thought to having surgery as

It has not been successful for them, it’s major surgery so I want to give it more thought. Any comments please on knee surgery.

[suzy1959 in reply to Birdboxinthegarden]

It’s early days for me yet- 8 days post op. I had to have the surgery as both my knees are bad and I haven’t been able to walk properly for over 3 years. My life has been completely blighted by this. The hip I had done last year went very well and I look upon that as having been very successful.I will eventually probably have 4 new joints! But I am thankful that there is a solution to this, PMR being less manageable!

[DorsetLady PMRGCAuk volunteer in reply to Birdboxinthegarden]

Had mine done last July - not on Pred at the time. The Pred will reduce the swelling and take away most of the pain - until you get to lower doses and then it returns.

Recovery is a bit painful for first couple of weeks - not the joint itself particularly, but at the back of the knee where it is bruised, and straightening the knee is difficult to start with, but if you ice it regularly and do the exercises it will be fine.

To be honest I don’t even think about it now, it does creak a bit when I bend it, but that’s mechanical and doesn’t cause any pain!

[Bamber99 in reply to Birdboxinthegarden]

Lack of knee pain and swelling was the best side effect of pred. At 10 mg pain started to return, at 6 now it’s significantly worse and I’m reluctant to reduce more. Unfortunately for me I need to lose weight before an op. I can’t really blame the pred for weight, I just love good food. Long term I guess it’s knee replacement or wheelchair.

[PMRpro Ambassador]

I'd stay where you are - but it is up to the surgeon AND the anaesthetist. Wait until you have done rehab before continuing on your merry reducing way...

[Mary63]

I would stick where you are.

I had a total knee replacement last week when on 7mg. I had been on 7mg since Sept. Failed to get to 6.5 by November (flare) , so decided to stick on 7mg till after Christmas and then op. Am considering starting slow taper to 6.5 again about 6 weeks post op.

[Retailmonkey]

I was told I had bone on bone arthritis in both knees 3 years ago (the result of playing professional rugby league) just before I had PMR/GCA confirmed. The steroids and starting to wear barefoot shoes with orthotics controlled the pain extremely well until I finally got below 4 mg at the beginning of this year since which time they have not been good. I return visit to the knee surgeon two weeks ago confirmed that I needed half replacements in both knees and so now waiting appointment for the first. His advice was to just continue as normal with pred, methotrexate and leflunomide but that we would discuss it again on my pre-op visit

[Jackoh in reply to Retailmonkey]

Just interested in why you are on Pred and both methotrexate and lefludomide. Is that because you have RA as well as PMR? Usually I know you are given methotrexate or lefludomide a steroid sparer. Just wondered why you have been given both?

[Retailmonkey in reply to Jackoh]

Not RA but GCA which kept flaring and wouldn't let me get below 5 mg of pred. After nearly a year on both, GCA scans are clear and am down to 3mg of pred

[Jackoh in reply to Retailmonkey]

Thanks