Hip replacement

[Seagu11]

Would this be wise if still on steroids even a low dose.?

[piglette]

I had a hip replacement recently on steroids.*

[polymy]

Yes I think it is fine on a low dose. Shouldn’t be a problem.

[Judyliz]

I think this really depends on how you feel about the procedure and any other medical/health conditions you have.

From my understanding the orthopaedic surgeons are generally happy to perform the surgery but are concerned about higher doses. They might or might not liaise with other specialists involved in your care. This will differ with individuals consultants and we have to remember we are more prone to infections and have slightly slower healing.

If you have reached the stage were your mobility is so affected that you are only able to walk very short distances and in constant pain then surgery is probably your best option.

Long term a more sedentary lifestyle will have consequences for your health, poorer cardiovascular function, weight gain, loss of muscle mass to name but a few.

If it helps I had a hip replacement on 11th June this year I was taking 12.5 mgs at the time. I did not have to increase my dose. I was able to walk with 1 crutch after 10 days and none after 2 weeks. By 6 weeks I could walk between 1-3 miles and now I walk between 8-10 miles twice a week, I also lead the WI walks, am back at yoga and able to bend and get down and enjoy gardening. Sheer joy. The relief of not being in pain and being more or less household was overwhelming.

I recognize my recovery has been swift and very unusual. Generally the advice from the physio is to use the crutches for around 6 weeks and during this time be reviewed. The physio is highly knowledgeable about what you can and can't do and I can only advise you if you decide to have the procedure follow his/her advice about exercise diligently. It will be uncomfortable, we have a big slice through our muscles but it definitely pays off in the end.

Good luck with your decision making.

Judy

PMR 2 1/2 years since diagnosis probably 5 years

GCA 2 years 2 months

[PMRpro Ambassador]

Some surgeons won't do it - so shop around. One lady was told by her GP she was too young at under 60 (but she couldn't walk) and she would have to be heading for 80! I told her to look around and one of the first local surgeons she contacted who did private work as well as NHS agreed to do it at 10mg pred. Once the hip was done she was able to reduce steadily to a very low dose - it was if the hip pain had been feeding the PMR. There are quite a few people on the forums who have had it done.

[suzy1959]

I had a hip replacement in June on 11mgs. Pred. The anaesthetist just gave me a steroid infusion afterwards and I had no PMR problems. Unfortunately because I also have 2 OA knees, my mobility is not much better and I will have to get the knees done. As PMRpro suggests, I think the OA and PMR each make the other worse. My Rheumy suggested that being in a lot of pain probably means needing higher doses of Pred. too. I do often wonder if having PMR made it more likely that I would get OA too?

[Valnvaughan]

I have needed 2 hip replacements this year. It was a no brainier, I could not walk! 3 1/2 years since PMR diagnosis and down to 9 mg Pred per day, osteoarthritis struck my hips. Surgeon seen in April asked me to reduce to 5mg per day, managed this before right hip replacement in mid May. 6 weeks later my left hip said NO to walking, I like resting and I was reduced to using a wheelchair. Surgeon was concerned that replaced hip would suffer if I could not exercise and speeded thru my second hip replacement in early October. Each operation I was given extra Pred to cope with trauma, but reduced straight down to my usual daily dose, now 2.5 mg per day with no change in PMR symptoms. Recovery is directed by hospital physios to be slow, as first hip is too young to carry the total load. So again in a wheelchair except for essential walking round flat, with expectation to start gentle walking at 6 weeks.

The level of Pred before an operation seems to be surgeons choice.

Best of luck. Valerie

[Bailybiscuit]

I had mine replaced last year whilst on 20mg pred. I didn't expect it would happen when the surgeon found out the dose I was on but he said that they operate all the time on people on steroids so it wasn't a problem. I healed very quickly and had no problems at all. I was dreading it but it couldn't have gone better. When they used to ask me to give a pain score each day I always said about 8 but that's in my knees, not my hip. I always thought it funny that I take Cocodamol each day and they would offer me paracetamol. I told them I needed my cocodamol for my knees but the nurses used to tell me I couldn't take the two together I would need to leave some time between them even though the two, codeine and paracetamol were in one capsule in my locker.