Hip replacement, PMR, and prednisone?

Does your surgeon have an opinion on the other options like kevzara? From my understanding, every treatment option for PMR suppresses the immune system. Maybe prednisone has a more widespread effect, but I'd hate for you to start kevzara or anything else only to find out that he won't do the surgery while you're on that or anything else.

I had a similar situation to you. I was diagnosed with PMR in August 2024. Prior to PMR, I was asymptomatic for hip osteoarthritis but the pain started around January 2025 and I had hip replacement surgery in March 2025. At that time, I was down to 5mg Prednisone and my surgeon was okay with 5mg or less.

I am not writing about surgery vs prednisone. I am writing about the possibility of your PMR becoming worse as an unintended outcome from joint surgery. I had my right knee replaced in Nov 2025. Very shortly after my blood tests documented serious anemia and high sed rate and CRP. Much medical stuff ensued. Nine months later I asked my new rheumatologist if I was experiencing an allergic reaction to the metal and stuff in the knee replacement. I have also developed a rash around my replacement knee. She said she doubted it but PMR frequently had a precipitating event. This left me thinking that if I hadn't gotten the knee replacement I might not have gotten sick with PMR. I realize you already have PMR but maybe a question to the rheumatologist about the possibility of your PMR getting worse if you have the surgery is in order.

Before PMR, I was scheduled to have a knee replacement. In office, scheduling a date with the surgeon, he did some test movements that made me “jump off the table” he wrote in his notes. He asked how long my hips had been painful during those movements and I told him it just started about a month or two ago. He ordered MRI’s and said come back afterward. I thought I’d have to do the hip surgery before the knee surgery.
Long story short, the hip pain was PMR. The MRI showed some hip joint deterioration in my hip opposite the knee needing replaced, but not bad enough to warrant replacement.
I saw him after being diagnosed with PMR and we both agreed to postpone the knee surgery until PMR was gone.

@stonewheel
You have a good surgeon. I had a similar experience. I'm thankful for those surgeons who understand due diligence.

After my knee replacement surgery and while having serious anemia and inflammation, I was rehabbing my knee with physical therapy. I had difficulty getting PT and keeping my stamina in PT. The two health issues combined to make PT much harder