Full knee joint replacement(s) at age 90

Surely any comorbidities (the very best 90 year old will have at least a few) and the pre op anaesthesia assessment will outrule such a big elective surgery?

Not a thing. You just choose how zonked you want to be and I chose fully. You wake up like you've been asleep. None of that awful after general wooziness. That's what I hate.

DH is a hip and knee surgeon. Her age wouldn’t prevent him operating, that would be down to any other comorbidities and how well she is in her health; but he would go through the pros and cons very thoroughly. He would NEVER EVER do both knees at once (he wouldn’t do bilateral hips either) and most decent consultants would say the same whatever your age, it’s really not the done thing anymore ~ yes, sometimes others would and IMO that’s around time and shunting people through quicker.

It should be noted that 1 in 10 patients who have a new knee are disappointed and that 10% continue to have ongoing pain.

And booking care for a good 6weeks post op is the best idea~Most patients only stay in 2-3nights post op.

Whatever happens, she will have a thorough assessment pre-operatively, and she should see OT and physio which should help. Good luck.

If she has one done, watch her like a hawk and if it hurts at all try to take her back to the original surgeon.

My DGM (89) had one done, all the physio, was walking really well for about six months. Then it started hurting — doctors said it was just the new knee settling, then bursitis, then septic arthritis. Turns out that her kneecap (they don't give you a new kneecap) had broken in two. She had to have it removed and has never managed to walk well since. It's such a shame.

The surgeon said if they'd caught it earlier they'd have tried to wire it (?), put her on bed rest, and then done the other knee so there wasn't as much pressure on the "good" leg.

So to me, both at once actually sounds quite good to avoid that (although I'm obviously not a doctor). I suspect recovery would be pretty awful though.

That's interesting. I'm contemplating it for my next hip replacement as I felt dreadful for a week after the general. But I gather it's a pretty brutal operation - were you aware of any of it?

I had spinal block and sedation for both my hip and knee. I'd choose it again for my next hip. I hate having general

Thanks for that - the only thing DM had told me is that it would be done under epidural and not involve a general.

That could be the case. I was offered that for my hip replacement and I think the anaesthetist referenced something about being appropriate for older patients with heart issues. I chose the general anaesthetic but I think you can have the epidural plus sedation if you need it.

I didn’t have a new replacement but a knee rebuilt. I was 40 - I totally underestimated the pain, was not allowed to weight bear for six weeks and recuperation took months.

id be worried, sadly, that your mum might never get out of that care home again.

I have to say that my two surgeries were NOT excruciating and that pain relief was on offer if I did. My problem was balance and that has been difficult. I'm still using a stick 18 months later. I think this would be a very ill-advised procedure for someone of 90.

I have two very elderly parents one in a care home.

I hope I am allowed to say I am heartily sick of older people deciding they will do what they want and stuff the consequences . After all they think they have you to pick up the pieces if the worst happens but of course they believe it won’t (at 90 plus).

You want to say OK do what you wish but don’t coming running to me if it goes wrong but they know and you know there you will be picking up the pieces again and again..

Has surgeon 2 spoken to his regular anaesthetist about her? At age 90, even with no major comorbidities, a single joint replacement is major surgery and comes with some risk. I would strongly suggest exploring whether there is an anaesthetic consultant pre-op clinic where they’ll be able to consider any other medical problems she has and give a better impression of her overall risk of morbidity and mortality if she proceeds.

It's a lot more than a few days. I had to live with my nan for a week as I couldn't manage my stairs

Thank you. My op was a few years ago now. It's excruciating for much longer than a few days. Removing the staples was painful. The numbness from the nerves is also painful and continues for a long time. Sleeping is very difficult because of the pain and getting comfortable in bed. I had every painkiller offered.

She'll never walk again if she does this

I feel for you.

what does "full recovery" mean? would something like jogging be okay?

I've had just one knee done. The pain is excruciating and full recovery takes at least 18 months.

I am in my 70s and had both knees done six months apart. There were no issues with the TKRs but my lack of proprioception balance is still very difficult.

That's really interesting @Fivehares and @FixTheBone

Bilateral joint replacements are much more common in private care systems as you halve some of the ancillary costs.

India in particular, I know it happens pretty frequently, the UK less so, I only did bilaterals twice in my training, so less than 1% of all joint replacements.

My friend turned 70 in September and has just had both knees 2 weeks ago today . In the states . He lost a lot of weight before the surgery , attended the gym 6 days a week in preparation for the last year to build muscle . He was discharged to a centre for physio for 2 weeks but they let him home as they trusted him to do the exercises and also his gym trainer is assisting him . He is in lots of pain . He iced his knees through the day . But he is determined to get walking and back to fitness . The work and effort he put in is phenomenal. The surgeon he used seldom does 2 knees together only on a rare occasion where he feels the candidate can withstand it .

Thanks @FannyCann - I'm quite a way along the process tbh - I am under a surgeon now and we've agreed to go for it at the beginning of 2023 so all being well I should have the op by late summer - I'm a single parent so making sure I've got care in place is vital - even though they're teens, they don't cope well if I'm out of action!!