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This has be a disastrous year for my 97 yr. old father requiring a tibial plateau repair and partial hip replacement all on his right leg. He survived both very well maintaining his mobility+. Unfortunately, a third fall (resulting from severely low blood pressure & dizziness caused by the inexplicable prescribing of Toprol during the hip surgery) appears to have resulted in a complex tear in the medial meniscus of the knee of the same right leg. He has been immobile for the past 6 mos., unable to put pressure on the knee w/o severe pain (10+) & experiencing jabs of severe pain (10+) at random. Opioids (e.g., oxycodone, Nucynta) & Celebrex have done little to ameliorate the pain. His orthopedist says an elective knee replacement is indicated but given his age is not doable, and his gerontologist suggests arthroscopic repair of the medial meniscus is unlikely to help. Living the rest of his life (nothing else is "wrong") totally immobile requiring help to go to the bathroom and in severe pain does not seem to be a rational prognosis. Does anyone have a suggestion as to how to proceed?

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The clinic system I belong to in my state has a pain clinic, where all options can be explored in a tiered priority. They only deal in pain mitigation. See if your dad has access to something like this.

Also, you may also want to explore newer therapies for chronic pain sufferers, like nerve ablation (which is minimally invasive and very low risk with good outcome) or PNS (peripheral nerve stimulation) -- sort of like TENS but there is only a 60-day stimulation period and then the unit can be completely removed with lasting pain relief, usually permanent relief.

Here is one to consider (disclosure: they are clients of ours but we don't have any sort of sales arrangement or gain any financial benefit from any promotion or recommendations):

https://www.sprtherapeutics.com/patients/stories/#knee

It is FDA-approved and has had fantastic results for its users, with very low risk. This is a fairly new therapy and that's why I'm posting it here since many docs may not be aware of it yet.
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Tears like that are very painful and yes a lot of times medications don't touch the pain.

The issue is your dad's age which limits treatment options by his ortho. Knee replacement is usually recommended based on size of tear etc. But some don't offer other solutions because they recommend the biggest money maker to patients. I learned this after my husband's back injury.

Did you ask ortho about arthroscopic repair? He will give reasons why this is not an option for dad and he hasnt recommended it. You can and should also seek a second opinion from another ortho if you do not like his answers.

Again his age really limits treatment due to healing factors and ability to do physical therapy. Which has to be done for the healing process.

Just curious what happened that he needed a tibial plateau repair and hip replacement and how long ago was this?

Overall your father should not have to live out the remainder of his life in pain. If no surgery is an option maybe a visit to a pain management clinic can offer some solutions.

On an ortho website they recommend glucosomine/chondrotin supplements and suggested a knee unloader brace.
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What does the orthopedist say about the arthroscopic repair?
Would it relieve some of the pain? Would it allow him to become mobile again even if it is a limited basis?
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