FWIW, when you say your knee is bone-on-bone, it's very likely that a TKR would be best.

It all depends on your level of pain and how it's affecting your day-to-day life. If you can't walk without limping, or if you can't walk up or down stairs, it may be time for a replacement.

I've read stories here about stem cell therapies, gel injections, and PRP injections. They may offer short-term relief, but to my knowledge, none of them will regrow lost cartilage or damaged/missing menisci.

I suggest seeing a knee surgeon, a good surgeon who won't jump to TKR without a thorough evaluation, and possible PT. Ideally, find a surgeon with a solid med school and/or residency pedigree - Mayo, Cleveland Clinic. I suggest someone in his or her late 30s to late 40s.

PT helped me immensely after my first visit with the surgeon. Eventually though, the pain would not go away and I had both knees replaced in 2022. Best decisions of my life. I am pain free and in the gym 7 days/week. I work with a trainer, lift weights, and take spin classes for cardio.

All the best to you! Joe