Any concerns if you have MGUS and need joint replacement surgery?

@wzls I had hip replacement in April of last year and my oncologist and orthopedic surgeon had no concerns about MGUS and it’s impact on the surgery and recovery or vice versa.I will say that my reaction to anesthesia and subsequent recovery seemed to be much tougher this time than they were 10 years ago when I had the other hip done. I don’t know if this was related to MGUS or not.
I am, after all, 10 years older. I do bring MGUS up whenever I see any provider but have yet to have anyone but the dermatologist talk about possible inner-specialty connections.
Good question though. Can you share your thoughts and information about this?

@hsminc listening as a hip may be in my future…however, I just had cataract surgery this week on one eye. The other was last year. They did not put me under general anesthesia. They only lightly sedate. I was out of OR in ten minutes and in an out totally in two hours. And I have smoldering multiple myeloma, no longer MGUS. Eye doc agreed it’s was best to get it done now in case I progress to the point I couldn’t gave it done. This doesn’t get better, it only gets worse (cataracts). You will be amazed once those cataracts are gone!

@amberl99 i am claustrophobic. This is why I am reluctant to have cataract surgery. My ophthalmologist at one of the “best” centers will only do cataract surgery if I am under general anesthesia. That will be 30 minutes for each eye. I have bolted out of CTs and MRIs. I do not ride elevators unless the ride is very brief.

@hsminc
I think this is an inherited trait. My dad (1910-1996); my grandmother (1867-1955); cousins, etc all appear to suffer.

@hsminc interesting. Not sure how claustrophobia plays into it since it’s just an ordinary room, not small. Well, good luck.

I have had four joint replacement surgeries in 10 years - all 15 years after being diagnosed with MGUS. I am planning a fifth for this summer. None of tbese surgeries had an impact on my M spike. However, each escalated my lambda free light chains. It is this effect that made me hesitate about this fifth surgery.
All surgeries went well and improved my quality of life.
The free light chains did not decrease to pre surgery baselines.
I have had MGUS for at least 24 years. It was diagnosed in 2002.

I've had both knees replaced and the MGUS didn't concern the surgeon. Everything went very well.

If you decide to have surgery, do it soon. I have had hip osteoarthritis for several years but at the time not severe enough to consider replacement. I went from MGUS to SMM to full Multiple Myeloma fairly quickly. Now 3+ years later, hip is worse but MM is in remission. After consultations with several surgeons, including ortho-oncologist, I decided that surgery at this point was not wise, and my age (85) figured in the decision.

@hsminc
FWIW...I had mine done at the mayo Rochester and can't do their normal sedation because I travel there alone and they want a designated driver with you for sedation. They use fentenol on me and I go through the procedures awake...but calm without issue. I have had two cataract surgeries, two angioplasties, and two carpel tunnel surgeries using this protocol without a problem

Thank you all for the responses and experiences. I have not found a surgeon who is overly concerned about the MGUS but was suggested that when doing the hip the posterior approach may be better than anterior to fully view the bone health and make appropriate adjustments if needed. Being a very active person with many animals the longer recovery is not ideal but may be wiser. In any case, MGUS is always in the back of my mind when thinking about any major surgery. I wish you all the best.