Over 7 million Americans are estimated to suffer from inflammatory rheumatologic diseases and the rate of joint arthroplasties are nearly 50 % higher among this population as compared to controls. Many of these patients are on glucocorticoids around the time of their joint surgeries. The optimum perioperative management of glucocorticoid dosing is not known and there is no established clinical practice. The most recent recommendation by American College of Rheumatology/ American Association of Hip and Knee Surgeons to continue home steroid dose rather than administer supraphysiologic stress dose for patients undergoing elective arthroplasties was based on a low level of evidence. The aim of our study was to compare the rates of peri- and postoperative outcomes after elective joint arthroplasties with continuing home glucocorticoid dosing versus administering stress dose steroid.