My father died six weeks ago at age 72. I'm still slogging through all his paperwork. I was reminded by some paperwork I found that he had a knee replacement three years ago. Looks like it cost him a fortune. Is it really worth all that money for a knee replacement in an older adult who isn't going anywhere? And then to die three years later -- ?

We appreciate how distressing it is to lose a parent and find yourself reviewing medical decisions that may look questionable in hindsight. It's often like they say, "Hindsight is 20-20" meaning that it's much easier and more accurate to look back over time. With perfect vision and clarity, we see what would have worked best. But in the day-to-day decisions, we don't always have such a luxury. Knee replacements are becoming increasingly common among all age groups (young to old). At age 72, some adults are still very hale and hearty and active enough to want the knee replacement. Reducing knee pain and improving function also improves quality of life. Sometimes that life is cut short and the full benefit of the surgery is lost. But given today's increased longevity (many more adults than ever before are living into their 90s), a knee replacement at age 72 could have conceivably provided your father with an extra 20 years of improved knee function. With no sure way of knowing who might live the longest to derive the most benefit, patients are rarely denied medical services in this country based on age. And in our country, there isn't always an easy price tag that can be placed on patient satisfaction. Patient satisfaction with knee replacement surgery is high based on pain reduction, improved function, and increased ability to participate in sports and recreational activities.

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