PMR and knee replacement

Having knee replacements done while on prednisone wasn't ideal according to my orthopedic surgeon. I had both knees replaced while on higher doses (30 mg) of prednisone. My surgeries were 2 months apart and done back-to-back. The surgeon was willing to do my worst knee first and the first surgery went well.

There were all sorts of extra precautions done prior to, during and after my surgeries. My hospital stay was longer after my first knee replacement because of the "additional precautions." Since my first surgery went well there were fewer precautions for my second surgery. I was discharged from the hospital within 24 hours after the second surgery.

I had both a "surgical management team" and a "medical management team." My medical management was headed up by an endocrinologist who made sure I received stress doses of IV steroids
and also made sure prednisone was restarted in a timely manner so I wouldn't have an adrenal crisis. Managing adrenal insufficiency during surgery was critical to prevent an adrenal crisis in my case.

I also had a history of a pulmonary embolism while on prednisone so an Inferior Vena Cava (IVC) filter was placed prior to surgery.
https://www.yalemedicine.org/conditions/ivc-filter-placement-and-removal
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Overall ... everything went well with both surgeries. I was able to decrease my prednisone dose somewhat -- down to 20 mg within a few months after my knees were replaced.

I had an "aberrant healing process" that showed up years later after my knee replacements. Prednisone probably didn't cause the aberrant healing but my orthopedic surgeon said I shouldn't have any surgery ever again.

Thank you for your insights. Appreciate you taking the time to post.

katie614 @katie614 Hi. I’ve only had PMR for 10 weeks, but have experience with knee trouble. I was scoped about ten years ago, but about two years ago osteoarthritis made it to where I couldn’t walk up steps anymore. Steroid injections did nothing for me. Then along came Hyaluronic Acid (sometimes referred to as a gel.) Currently it has beenapproved for only knees in the USA. (For several joints in Europe.) It works like magic for me. It can be repeated every six months. I have had four injections to date (2 years.)
It takes about a week for it to get situated in my knee after the injection (some people up to three weeks) but stadium steps are no longer a problem. I’ve never gone longer than six months without getting reinjected so I don’t know how long an injection would truly last for me personally. I just schedule it every six months as the law allows.
Has your orthopedic surgeon offered you that option instead of steroids injections? If not, ask.
I got my fourth injection while my PMR pain was increasing but about six weeks before my PMR diagnosis. I’m glad I did.
I know that there is a required passage of time after a steroid injection, that you have to wait before surgery at that location can be done. I forget how many weeks or months it is. Surely your surgeon has or will tell you.
I’m on the treadmill (Prednisoned) right now keying this comment. Hoping the best for you.

I had my knee replaced on 10/3/25 and was diagnosed with PMR on 10/16/25 and started on 20 mg of prednisone. Got down to 9 mg and a flare. Back up to 15 mg for the flare and I’m back down to 9 mg. I’ve had no issues with taking prednisone and my knee. I don’t recommend having both at the same time but who gets to choose?

I recall checking in for the surgery with my PMR in full bloom. So much pain between the knee and PMR. I don’t think you can ever wait for the right time. Just do what you have to do and adjust.

t you have to do and adjust