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Her doctor won’t do knee replacement. She’s in constant pain. What should I do? I hate seeing her suffer.

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Imho, she needs a pain management specialist.
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The Dr. has reasons for refusing replacement. Then get her a "pain management" Dr. The longivity of pain will do things to her brain and body and she will "go downhill".
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If you've exhausted your options such as a second opinion, alternatives to general anaesthesia,etc., then I would suggest a consult with a pain management specialist.
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Geaton is spot on!

Very unlikely that any anesthesiologist will put her 'under' although sometimes these kinds of surgeries can be done with spinal anesthesia. You'd need a consult with an anesthesiologist to see if she qualifies for that.

I have a friend who is in her 70's and she put off knee replacement for quite a few years by having the gel type injections.

She should be able to take something by mouth for the pain. Nobody needs to live in constant pain. A pain management dr could help with that.
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There are minimally invasive options that don't require pain meds:
- gel injections (my mom's done this and it worked in one knee but not the other)
- nerve ablation deadens the nerves transmitting the pain. Nerve may grow back but I think the ablation can be done again.
- peripheral nerve stimulation (a temporary lead inserted at a strategic spot that interrupts the pain nerve transmission). This is different than like a TENS unit and is fairly new on the market but has a 72% success rate and once it works it doesn't need to be repeated.
Keep pursuing these at your ortho pain clinic -- don't give up! There are options!
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Have you consulted a pain management specialist?

Also, here is some information from the Mayo Clinic site:

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/troubled-by-knee-arthritis-but-not-ready-for-knee-replacement
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Her heart may not survive the surgery. A man we knew recently died from complications from knee surgery. He suffered a couple of strokes, then it was found he had CHF and needed bypasses. Couldn't do the bypasses because of his CHF.
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