Hip replacement and steroids

[jaycee444]

Am on the list for hip replacement . Have been asked if I could come in at short notice if the opportunity arose and said yes but cant really see that happening. I certainly wouldnt want to go in before Ive had second Covid vaccination. Just wondering about the Prednisolone situation with regards to surgery. Am at present on 9mgs and reducing Img per month - although I sometimes stretch that out to six weeks. Will I be expected to b e on a really low dose before I can have surgery?

[DorsetLady PMRGCAuk volunteer]

You need to discuss steroid situation with anaesthetist pre operation.... but I doubt if 9mg will be an issue.

As for the operation I would go for it.....it will be easier to rearrange your second Covid Vaccine-than another operation. You may yourself well down the list,,,,and could be waiting months for it. .,, and in severe pain if it’s anything like mine was.

[jaycee444 in reply to DorsetLady]

Thank you DL. Yes the pain is a real issue so I will certainly be glad to get it done.

[piglette]

I have recently had my hip replaced. All the staff were checked for COVID regularly and the nurse I saw at the hospital last Friday said she had had both her vaccines. So probably most of the staff will be in that situation. The reason you may be called in at short notice is if someone else has had to cancel their op, perhaps they have been diagnosed with Covid or for anything really. My surgeon wanted me at zero pred, we agreed on 5mg. I would have thought they would be happy with 9mg. If you can have your hip done at the moment you are really lucky and if I were in your situation I would grab it.

[PMRpro Ambassador]

No - it is better to just stick to your usual pattern and you are already below 10mg - so far better not to risk a flare which might mean you couldn't have the surgery. You will require a steroid boost during surgery probably - but that is entirely up to the anaesthetist so make sure they know, make sure you tell EVERYBODY that you have been on long term corticosteroids if it comes to that!

[Mary63]

I have had three knee ops since having PMR. For my total knee replacement two years ago there was no problem me being on 7mg, and for an arthroscopy a year earlier I was on 12mg I think. Again no problem The anaesthetist gave me IV hydrocortisone during the ops. I did not have a flare and just remained on my usual dose.I would go for it!

[suzy1959]

I have had 2 new knees and 2 new hips over the last couple of years, always on 11mgs pred. The anaesthetist sorts out what you need both during the surgery and after. I always flared afterwards, possibly due to pain and, I suppose the trauma to the body. I have, however made a good recovery after all ops. Hips are less painful than knees and recover quicker as long as you heed all the instructions.

[jaycee444]

Thanks for all your comments - really appreciated. Had one hip replaced pre PMR so I know what a difference it will make being free from the pain.

[123mossie]

Hi Jaycee I had my hip done 2 wks ago, on 5mgm steroid. The anaesthetist just said carry on . I was ok till 3rd day post op when I flared. I added 5mgm then went 9. 8,7,6 & back to 5. The flare settled in 6hrs or so. My surgeon wasn’t bothered about the steroid dose at all. There were very strict Covid protocols & I felt quite safe, though I did have to isolate for 14 days prior to admission, + negative test.

[Walktogether]

I had my hip replaced just before Thanksgiving. I had dosed down to 10 mg. and had no problems. The Covid protocols put into place at the surgical center were very strict, so I felt very safe. I hope you have the same positive experience as I did. I wish you well.

[pegpowell]

I had a knee replacement four years ago on 6 mgs. One month before the op I had steroid shots in both knees and L hip. I had a flare shortly after the op but it took three weeks and trips to the ER (they couldn't figure out what was wrong with me) to recognize. I went up to 15 mgs and dropped quickly back to 7 mgs. I am not looking forward to replacing my left hip after my second COVID shot next month. I am currently on 3 1/2 mgs, been on for quite a few months now. Started on 15 mgs five years ago. I am 82 and may consider an outpatient cooled radiotherapy (COOLIEF) ablation of the nerves instead. Haven't decided yet. As you can see from your responses, it doesn't matter if you are taking pred. Just be aware that you may need more after the op.