Surgery with PMR and Prednisone

Posted by ste44 @ste44, Dec 12, 2023

I need shoulder surgery. Have any of you had problems with surgery while on prednisone for PMR

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Good Morning, I was diagnosed with PMR around the same time that I had scheduled shoulder surgery for a painful bicep tear. Needless to say dealing with both issues was not fun. My ortho surgeon said that I should not begin to take prednisone until a week after surgery. This was very difficult as I seemed to be hurting all over. In your case, you may have to stop the prednisone for a time before surgery. In any case talk to your surgeon for more info. As an aside, I rented a medical grade mechanical chair (for a month) to use after surgery. It was a godsend as I could then sleep much easier and it helped me to get in a standing position with ease. Good luck Liz Ward

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I’m having knee replacement surgery in April and my surgeon is ok with 5mg or less. I’m on the rd to tapering down so hope to be off completely by April.
Good luck

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I need about 3 surgeries and asked my rheumatologist at what dosage of prednisone would I be able to have these needed surgeries and she said I would have to get down to 5 mg.

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@ste44, you may also interested in this related discussion where @stleg asked a similar question last year
- Not a candidate for elective surgery due to PMR or steroids? https://connect.mayoclinic.org/discussion/elective-surgery-1/

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I had hernia surgery last January and was on 5 mg of prednisone at the time. No problems. Took my prednisone as I normally would both before, day of and afterwards.

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I had a rotator cuff tear along with assorted other shoulder issues and a trigger finger several years ago while on 15 mg Prednisone for PMR. Neither the orthopedic surgeon nor my rheumatologist had any issues with my having the surgeries, which were successful. The recoveries were not any different from when I had similar surgeries on my other shoulder years ago before I had PMR.

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I had a hip replacement while I was taking 2 mg. prednisone. Had no issues.

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I don't recall the exact dose of prednisone I was taking before my knee replacements. It was at least 25 mg of prednisone daily but the orthopedic surgeon had no problem with my prednisone dose. The surgeon just took every precaution imaginable because I was on prednisone.

One precaution taken was a medical management team that supervised my medical needs during and after my knee replacements. The medical doctors made hourly rounds to make sure I was doing well. I hardly saw the surgeons after my surgeries. The surgeon didn't seem concerned about any "surgical" complications.

There was much concern for "medical" complications.

"The number of patients exposed to steroid therapy prior to surgery is increasing. When these patients present for surgery, the anesthesiologist must decide whether to administer perioperative steroid supplementation. Stress-dose glucocorticoid administration is required during the perioperative period because of the possibility of failure of cortisol secretion to cope with the increased cortisol requirement due to surgical stress, adrenal insufficiency, hemodynamic instability, and the possibility of adrenal crisis."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861897/
I remember watching the bag of hydrocortisone dripping as it was being infused via IV.

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