I need a knee replacement and am taking Prolia, and the thought of a challenge hadn’t occurred to me! Though I hadn’t thought to mention an osteoporosis drug to my Orthopedist, nor my need for a knee replacement with my Endocrinologist.

Prolia is the only osteoporosis drug I tolerate. I’ve never had a challenge and just had my 5th injection, after having stopped to try Evenity and then Tymlos to build bone, I’ve returned to Prolia. I’m 63, and am told I’ll be on it for the rest of my life, because the ‘bone builders’ caused severe side effects.

In researching, I found the following research study finding that Denosumab (Prolia), actually is beneficial with knee replacements specifically!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434591/
Interpretation

Denosumab reduces early migration in total knee replacement, as in previous trials using bisphosphonates. As migration is related to the risk of late loosening, denosumab may be beneficial for long-term results.