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

@wzls Welcome to Mayo Clinic Connect! I have heard the same thing, and a friend of mine says her MM was brought on earlier than expected due to joint replacement surgery.

What joint is giving you the problem? What does your medical team have to say about this school of thought?
Ginger

I have had four joint replacement surgeries since diagnosed with MGUS in 2002. This included two knees, a hip, and a shoulder. All surgeries went very well; they were done at Mayo in Rochester.
I put off having the knee replacement surgeries because I was afraid of progressing. The hip was necessary - could not walk.
All surgeries affected the free light chains. The last surgery (shoulder) increased these FLCs the most. My M spike did not increase. My involved lambda over not involved is now 15.3. It has decreased since after the surgery when it was 17.
I hope this is helpful.

PS Despite being diagnosed with MGUS in 2002, I still am categorized as MGUS.
Each joint surgery (2015, 2015, 2021, 2023) increased the FLCs but not other indicators like the M spike (1.3) or plasma cell labeling index. I have IgG lambda.
I was surprised and charted this cause of Covid shots - no relationship.

Just based on quick research, joint replacements did not increase risk of cancers. MGUS is a quirky syndrome in which autoimmune and plasma numbers can go up and down through time, so it is hard to tie personal experiences to cause and effect. I'm 71 and have had my IgA kappa MGUS for 8 years. With MGUS it is important to treat yourself well, healthy diet, avoid stress, enough sleep, and find fun things to do every day. https://pmc.ncbi.nlm.nih.gov/articles/PMC2361975/

Thank you Ginger for responding. I was just diagnosed with MGUS so all is pretty new to me. My second round of bloodwork to check on any changes won’t be until Aug. My replacement surgery would be a shoulder that is bone on bone. I just saw the surgeon and he was not concerned with my MGUS, but I had not found this article in the NIH National Library of Medicine that mentions the possibility of an elavated risk of MM when I saw him. I imagine this is a question for my hematologist anyway but I wondered if anyone had any experience with this. Thank you again. Peggy

@wzls Please let us know what your hematologist's opinion is, okay?
Ginger

I will Ginger. Thank you

@hsminc
what a coincidence, I just got hip replacement on April 1. I know… It is sort of a challenge to the gods of MGUS to get hip replacement on April fools Day. Many friends reminded me that this was a challenge worthy of a much younger person. I got hip replacement in 2016 and it went so smoothly. Same surgeon same hospital fast-forward to 2025. I don't know if it had anything to do with MGUS, but I had a really rough first week post surgery. Pain medication typically makes me nauseated so I avoid it and I took very little of the prescription medication. I truly did not have a lot of pain but I was nauseous for that first week. Even the thought of food or the mention of food was enough to trigger a response. I'm almost 10 years older than last time so again, I don't know the cause.
Day eight I decided I'd had enough of that and I was going to eat regardless. So I did and began to feel better. Since then, I have had what I would describe as an easy recovery. It is annoying to me to have to use the walker but my surgeon insists that I do for six weeks and then six weeks on a cane. Since he's the bees knees of hip replacement and knees I will comply. he will be quick to tell you that he did Terry Bradshaw's knees and it is almost as though one has to request an audience to get an appointment. He is good though and I've had absolutely no complaints about my other hip.
So now I have a matching pair and I can endure twice the scrutiny at airport screeners. Yay!
Best of luck with your surgery. When your hip tells you it's time… It's time. I don't have an appointment with my hem/onc doc until July so we'll see how the numbers go but I feel good right now.

@hsminc PS, prior to arranging for this surgery I did talk to my hem/onc physician who said that it would be safe to have the surgery. My numbers have been stable since my diagnosis three years ago.
Yes, do let us know how things go for you.

My numbers were stable between surgeries. It was after each surgery starting with the first knee that my free light chains escalated, never to return ro baseline values.
I charted everything else includinfg M spike, kidney and liver values as well as the CBC. NONE of these have changed over time - they are the same as 10 years ago, 15 years ago. I do not understand except the free light chains have an inflammatory “role.” I would expect the M spike to rise also.
The plasma cell labeling index that measures cells with CD38 has also provided no correlation whatsoever.
If you have any ideas, please let me know. My husband thinks it the protheses’ hardware.