Would You Recommend A Full Knee Replacement For An 86-year-old

Posted on Sun, 25 Nov 2018

Question: Would you recommend a full knee replacement for an 86-year-old who has 1) recently been diagnosed with prostate cancer and had Firmagon shots in July 2018; 2) recently experienced some cognitive decline, but still lives independently; 3) appears to have white matter small vessel disease; 4) has an unsteadiness (for an undiagnosed reason); 5) had a heart attack, but full recovery, three years ago.

His doctors have all given him clearance, but, I just want to be sure we are not taking an unnecessary risk. He had successful hip replacement, for both hips, a decade ago.

Answered by Dr. Dr. Praveen Tayal (1 hour later)

Brief Answer:
Can undergo a full knee replacement.

Detailed Answer:
Hello,
Thanks for posting your query.
At the age of 86, some unsteadiness and a small vessel disease in the white matter can be related to atherosclerosis and do not affect the knee replacement.
Prostate cancer is being treated and he has recovered fully from a heart attack. If the anaesthetist has cleared him and he has a normal cardiac function- ECG and ECHO then there is no need to worry. He can undergo a full knee replacement to increase the quality of his life.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Praveen Tayal (14 hours later)

He has not had a recent echo but his EKG looked good. He had a MRI of his cervical spine done and it showed fluid accumulation in the shoulders and the CT of his brain showed mildly enlarged ventricles. What are your thoughts on the possibility of normal pressure hydrocephalus and a possible CSF leak?

Answered by Dr. Dr. Praveen Tayal (4 hours later)

Brief Answer:
Depends on the extent of enlargement.

Detailed Answer:
Hello.
Thanks for writing again.
Mildly enlarged ventricles are not always associated with a CSF leak risk. It depends on the extent of enlargement of the ventricles. Adequate hydration can help in preventing this.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar