Knee replacement surgery

[CEAGLE]

Have finally gotten down to 2mg prednisone but need knee replacement. What are the odds I will flare?

[Mary63]

Nil. I had a total knee replacement 11months ago. No flare at all.

[CEAGLE in reply to Mary63]

Thanks so much for your reply. Comforting to know

[SheffieldJane]

Talk to your surgeon. They may recommend that you take more Pred to support you through this.

[CEAGLE in reply to SheffieldJane]

Will do that. Thanks

[PMRCanada]

You may not flare at all! My two ortho surgeons described the process of patients who are getting tkr surgery get a high dose of hydrocortisone both before and after the surgery, to replicate what the body would normally do with a functioning adrenal system.

I was also told my risk of infection, after having been on pred over a year, rose from 1-2%, up to 4-5%, given the effect of pred on skin/healing, and compromised immune system (if I remember correctly). This was about 5 months ago when I was on wait list for tkr. Since weight loss and increased activity I have literally no more knee pain. I go back Tuesday to see what the plan is but I’m pretty sure we will delay the surgery for now.

Most folks I’ve discussed the surgery with, who have had it done, report resuming their usual dose after surgery, it was the rehab that can be more difficult given the need to go slowly as to avoid DOMS.

Good luck!

[CEAGLE in reply to PMRCanada]

Thank you

[Bonnie-ma]

When I had my TKR I was taking 2mgs of Pred. Mysteriously the discomfort of my PMR disappeared post my surgery. It was as if my body was too preoccupied with my knee! During surgery hydrocortisone shot administered. No increased dose of Pred pre/post operatively was recommended. This lack of PMR continued for several months until it began to return as my knee healed.

I would just say that you might take extra care to make sure your wound is healing well. My range of movement/knee bend was far too good and put some early stress on my wound. All fine in the end. I remain on low dose Pred.

[CEAGLE in reply to Bonnie-ma]

Thanks

[Hidden]

I had a total knee replacement in February 2019, at the time I was on 15 mg of Pred. All went well and I was fine! I continued to taper and everything went well... no flare until the summer, when I got cocky and tried to do too much. Good luck!!!

[suzy1959]

I'm afraid that I have flared after each of my joint replacement surgeries, but you should know that I flare with the slightest provocation! Pain makes me flare. But it's not the end of the world- I have survived! And I have come through all 3 ops and healed well despite the Pred.!

[CEAGLE in reply to suzy1959]

Thanks Suzy. How did you handle your flares. How much did you have to increase your dosage and how long have you been on prednisone?

[suzy1959]

My Rheumy has given me vials of Depo-Medrone that my local practice nurse injects when I have a flare. It means that I don't usually need to change my oral dose. I am usually on 11mgs Pred. and have been for most of the 7 years I have taken it.

[CEAGLE]

Thanks for the feedback. I will mention to my Rheumy