Ralph doesn't have a good run left in him. His knee is trashed, he's on opiates to deal with the pain, the rest of is body is breaking down. He has bed bugs and hasn't had a good night's sleep in over a year.
Ralph is going to hit one more big hurdle and tap out. He's going to try to visit this hooker Scarlett but I would be surprised if he even makes it out of the airport.
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He's going to end up dead somewhere away from home, his cats will be trapped unless someone can figure out where he lives and have them saved. Xander will never get to play peek-a-boo behind plexiglass ever again.