Knee replacement in older people

[Henrys Cat]

Hi all, I hope you've had a good Easter.

Does anyone have any experience of what happens when a knee needs replacing but the person is probably considered too elderly? I've had a Google and can only find lots of info saying don't leave it too long or it will get worse / recovery slower / recovery might not be as complete etc. My Dad (86, Parkinsons, plus loads of other issues) has been talking about the fact that his knee is shot for years. He told me several years ago that it needs replacing but of course they won't do it. Fast forward to me taking over his complicated medical care and pushing his knee to the bottom of the very long list. Now he is in a home and I'm not in control of any of the medical issues aside from having to take him to appointments (not the GP though). As far as I can make out, he has no current treatment or plan in place other than painkillers. Despite this, it still aches etc but more importantly it has started giving way. Do people get to the point where their need for a replacement gets so severe that they just become bed bound? Is there any other remedy, treatment, bracing etc? How old is too old?

Thoughts as always, gratefully received. xx

[bowlingbun]

I have 2 knee replacements, due to damage in a car accident.
It's a painful operation and recovery takes time and involves a lot of exercises to get full benefit. I was about 57, well worth doing for me, I'd always been a keen walker and when I was 18, was leading mountain walks in Switzerland.

They can be done in an elderly patient, but there are risks. Is the patient fit for surgery. Will the patient be able to cope with the post op exercises etc?

[Henrys Cat]

He can hardly be bothered to move now unless it's really necessary. I very much doubt that they'll do it because of the risks and the lack of commitment but I have no idea what happens if they don't it. I've no doubt said before that with all his other complications, this was wasn't / isn't life threatening so a few years ago when they last discussed it they probably didn't anticipate him still being around for his knee to become such an issue.

[susieq]

My Mum had her first knee replacement in her late 70's - it was very successful except that she showed an intolerance to morphine (very strange hallucinations !). Her 2nd knee replacement ((in her early 80's) wasn't so successful as by then she had developed Alzheimer's and didn't understand (a) why she was in hospital and (b) why she was in pain. Trying to get her to do her exercises after the 2nd op was almost impossible - it hurt therefore she just wouldn't do them.

With hindsight we believe that the problem with morphine after the first op was, in part, responsible for her developing dementia as, up until then, there had been no indication that she would be a likely candidate to get it.

[bowlingbun]

I have heard of so many elderly people developing dementia after surgery, that I've come to the conclusion that surgery has to be an absolute last resort to any medical issue in the elderly.

[Charles_2112]

My Mum had one knee done but the second op was delayed and she developed heart issues, making her a very poor risk for surgery. Since then her heart has got worse and she now has dementia. The other knee has got to the point where she has to use a frame or she will fall as it will give out without warning.

Her GP hasn't offered anything else as yet, although we are having discussions about it...not clear on what the options are at present though, as we've just started.

[Henrys Cat]

Hi Charles - I'd be really grateful for any information you find out in the course of your discussions. Dad had another fall last week (at least this one was recorded) and they said it was because he hadn't called for help to go to the loo. *sigh* He hadn't needed help until he went into residential care and that wasn't the cause of him falling! I think it was more to do with his sight loss and getting the arms of the chair mixed up but he's definitely finding it harder to get around. He prefers using his walking stick instead of the frame because it's wider than his legs but of course has no feeling so not ideal for a blind person but sometimes he has no choice. I just hate the thought of him ending up bed bound over this because despite all his complications he is doing okay and keeping going.

[Charles_2112]

Currently there seems to be a lot of head shaking going on, and I don't expect there's much they'll be able to do. Mum's using a frame but struggles with it.

It might be worth looking into the possibility of a quad stick: my Dad had one and it cut down the risk of falls massively.

[Henrys Cat]

Thanks Charles, I'll ask the care home if they have one for him to try. His sight loss makes things extra tricky because we'd have to let him have a feel of the quad part so he can understand that it's really stable but wider than his normal walking stick.
We took him for a walk through the care home with the frame this morning with the sensory loss advisor and it was slow and difficult, mostly because of the frame. He had said he couldn't walk at all so we compromised on me wheeling the chair in case he needed it. I think he's losing confidence. I'm going to start another thread because this is a slight aside but I may have to just give up trying to keep him mobile because it feels like a very lonely path at the moment!

[Justin_2205]

I studied this topic back in university. Hip and knee replacement surgery - replacing a worn-out joint with an endoprosthesis to restore its function and improve the patient's quality of life - is a complex high-tech procedure. Therefore, a preoperative examination of the patient, the selection of the appropriate type of endoprosthesis for each specific case, and the strict observance of recommendations after surgery are of great importance. Such prostheses are perfectly acclimated to the body. Such surgeries are very expensive, so you can't do without an auditor in such cases https://fortismedicalbilling.com/tennessee/. Modern medicine offers many options for helping the elderly!