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My best friend and I have been friends since 7th grade. we are 70 and 69 yers old and have had children we raised together till about 4 grade when they went to different schools.

we have been had times when because of work we did not speak for months.

Anyhow we are both having medical issues but I go to doctors and do what they tell me (including physical therapy).
My friend who is a retired nurse has not seen a doctor for years except for a pain clinic. she recently was in the hospital for neuropathy and cellulitis.she is very overweight and has the need for a knee replacement. she can barely walk and will not listen to what they tell her. Her answer is that she is a nurse and knows more.

My question is can I go behind her back to contact her children to see what we need to do.

No, unless she's had virtually no contact with her children, meaning they have no idea of her poor health. As a nurse, your friend knows what's wrong with herself, what her options are (how to contact a doctor), and for some reason, is choosing not to pursue care. As an adult, she's allowed to make these decisions for herself, even if they lead to worsening health issues.

You can go behind her back, but only do so knowing it may very well put an end to the friendship; is it worth it? You get to make choices for your health care, and she gets to make choices for hers. I know it must be hard for you to watch your best friend decline in health when she could take a more active approach, but by betraying her (unless you tell her outright that you've been thinking about talking to her kids about her health), you will add that layer of hurt to her life that she will have to deal with for the years she has left.

You are not a medical person but a friend in this situation so what you decide to do is totally up to you.
There's no way anyone that's good would do a total knee on stone woth a recent cellulitis without ensuring its totally resolved. If her BMI is over 40 that too is a contraindications for total knee.
If she is choosing to make bad decisions I would first ask what's driving that. I would also ask her what it would take to get to the point she needs to be for surgery. If she's been retired for some time she may not be aware of how much things have advanced in care as well.
If she has diabetes which she most likely does she probably qualifies for a semiglutide to help with weight loss. But if her neuropathy and pain are so bad she is hopeless thats her prerogative. As frustrating as that can be, we cannot prevent people from making bad decisions.
If this is a change from who she has always been then yeah she may need evaluated for depression and age related cognitive changes. In that instance I would not hesitate to reach out.

Thank you both . She just gave up and I feel hopeless.

My question has been answered and I will just keep trying to be a supportive friend.

It's sad but there's definitely a trend of patients with chronic pain not being well managed due to the "opioid epidemic" giving up committing suicide etc. It's very very sad.