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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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My father-in-law is 92 yrs young. In excellent health, except

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My father-in-law is 92 yrs young. In excellent health, except for arthritis in his knees. Very painful for him. We have had two different dr. opinions - with two different answers. He needs a total replacement. One Dr. thinks he should do it, so he no longer has the pain. The other Dr. thinks it is too risky at his advanced age. Is worried about the effect of medications from the surgery and pain on his memory and/or effecting his abilitiy to leave alone.
We would like to get your opinion. How long and what is the recovery process for this type of surgery for someone that is he his age? THe family just wants to make sure he/and we understand the risks and benefits. THanks

Mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Mysticdoc :

Hi there,


I am Mysticdoc, experienced Internal Medicine Specialist.


I am here to help you with your concerns.

Mysticdoc :

The major complications of this surgery are:

Mysticdoc :

1. Infection--1-2% can get it and may become life threatening.

Mysticdoc :

2. Blood clots-- in the legs and then travelling to lungs 10-20% risk.

Mysticdoc :

3. Patellofemoral disorder-- problem with knee cap and hence pain, instability --can happen following surgery in up to 10% cases

Mysticdoc :

4. Nerve injury causing foot drop--uncommon

Mysticdoc :

5. Blood vessel injury causing bleeding or circulation problem --5 to 10% cases.

Mysticdoc :

6 periprosthetic fractures-- fracture around the prosthesis following surgery can occur in some cases requiring another surgery.

Mysticdoc :

Benefits: Pain relief and improved mobility are the major benefits.

Mysticdoc :

However up to 20% patients may still experience pain following total knee replacement.

Mysticdoc :

Also if your father in law has any pre existing heart or lung conditions, the risks are increased further.

Mysticdoc :

So, in brief, risks are more compared to the benefits at his age.

Mysticdoc :

are you able to read my replies?

Customer:

What is the recovery time and process?

Mysticdoc :

Recovery time is usually 3 to 4 months.

Mysticdoc :

initially antibiotics and anticoagulants are used for a week or o to prevent infection and blood clots.

Mysticdoc :

Then physical therapy is initiated to achieve the best funtional capacity.

Mysticdoc :

Physical therapy initially focuses on the strengthening of the muscles, then balance and gait training and then active range of exercises.

Customer:

Would he need to go to a nursing home for a while?

Customer:

How long does physical therapy last?

Mysticdoc :

Yes w call it subacute rehab facilities.

Mysticdoc :

usually 3 weeks

Mysticdoc :

then h can get physical therapy from home.

Customer:

Is there a possiblity of memory loss for the medicines?

Mysticdoc :

Yes there is --that is a unique problem at his age.

Mysticdoc :

anesthetic medications used can cause this problem.

Customer:

Do you know the % of risk for memory loss?

Mysticdoc :

yes 2-5% risk

Customer:

Is this was your father - at 92 - would you have him go through this surgery?

Mysticdoc :

No I will not given the multiple risk factors

Customer:

Thank you....

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