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Basically the bone is dying from lack of blood flow. he is having a lot of pain and does not like to take pain medication because he does not tolerate it. plus he is afraid he will fall and hurt himself. the MD tells us his only option is to have knee replacement surgery. I'm very worried about him having the surgery, plus him dealing with the recovery PT and the pain. Do you all feel he is too old? I would like some advise maybe from personal experience with a loved one. thank you

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Purdy, my stepdad had a hip revision (second time replacement) when he was 83. He has done well with it. However, the anesthesia when used on the elderly can cause cognitive issues. Following SD's surgery he became very confused, did not know where he was or why. His reaction to the anesthesia was frightening for him and everyone involved. Sometimes the cognition improves, returns to normal, or remains causing dementia. Thankfully after about three weeks his cognition returned to normal.Surgery on an elderly person should be carefully considered.

In my mom's case she was diagnosed with uterine cancer when she was 80, had the hysterectomy, and became extremely confused following the surgery to say nothing of the effects that chemo may have had on her brain. She had been diagnosed with dementia in 2005. Following the surgery the dementia continued to progress, albeit slowly. She is still alive, was moved to a memory care facility in late May, where she is having a very difficult time.

I would make sure that you discuss the possible effects of the anesthesia with you dad and his doctor. If your dad is competent now, and he may not be after the surgery, the decision to have the surgery is his to make. Also, if he decides to go ahead make sure all of the legal documents are in order. Powers of Attorney, Will, Trust (if there is one), DNR, Medical Directives. If dad has an elder law attorney check in with them before the surgery. Make sure the documents reflect your dad's wishes at this time, sometimes they change.
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I was unfamiliar with this as well, but after reading up on it it seems to me your father has two choices.
No treatment will lead to eventual total collapse of the knee and eventually becoming totally unable to bear weight on the joint, as well as the continued pain associated with it.
Assuming he is not able to take advantage of any of the other treatment options available, a knee replacement, which would cause short term pain and disability but would hopefully give him back his mobility.
The difficult part is the surgery itself... I expect the surgeon would not be willing to go through with it if your father's health was fragile in other respects and there isn't a good chance of success. It never hurts to ask the doctors "If this was your dad, what would you do?"
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I don't have personal experience with this but this site is full of folks who have gone through almost everything and I'm sure you'll get someone who has had some experience but I wanted to weigh in with just a thought. If your dad has surgery he's going to need pain medication and if he's concerned now about falling having knee replacement surgery will put him at a greater risk of falling.

How does your dad feel about having surgery?

What is his prognosis with the avascular necrotic femur? Has his Dr. discussed the risks vs the benefits?
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