That is the most precise and informational post on this site since I became on board. I thank you for your extensive reply.

After a visit to the orthopedic Urgent Care yesterday, as I could not flex past 110* nor get below 12* on my un-operated knee, with major pain with any weight bearing all of a sudden. Did not hear a pop... just the bone on bone is begging to be noticed. My x-rays are significantly worse since just less than a year and a half ago (I thought walking was good and lubed our knees?). Hence the quest again for the best techniques and surgeons.

I've made a list of Nano verses Jiffy or even traditional. The Jiffy surgeons in my area (Ohio) have all been recently trained (August) and their training was to perform 10 surgeries under the Dr. Patel tutelage. I suspect most surgeons on that Jiffy list are in the same boat, as when I checked last year, the list was much smaller. So I looked up their backgrounds, reviews, health grades, experience... Some of these surgeons are definitely looking for the newest, sparkly money-maker ( training in arthroscopic sports medicine training?)... I'd at least expect some certification in orthopedic surgery thank you. Some trained as general surgeons, no specialty residency. Intriguing was a surgeon trained in pediatric orthopedics... (kinda thought that he may be used to working in tight spots?). It's a crap shoot and so much work. I miss my old insurance's Healthcare concierge coach. I wish we had access to some of their patients!

My first surgery Dr. rated in top % in America, a Center for Excellence program through our insurance. Everything was really absolutely wonderful. The care was top notch from the get-go until discharge. Every single aspect patient care and comfort were top priority at Northwestern University Medicine, Illinois. I was a healthy person who did +10,000 steps a day, health diet, non-smoker, good weight... What happened?

PT was delayed until 7 days after surgery once home (4 hours away) due to nurse sent to home had Covid, fired her...delay... Once initiated, I was diligent in my out-pt PT, 3x/week with doing exercises at home... I just couldn't extend and flex my knee well no matter how hard we worked. Maybe using crutches contributed (everyone I know used a walker- my Dr. wanted crutches). Maybe I just formed extensive scar tissue no matter what?

At the 6 week post-op it was mentioned he could fix it while I was under for the second knee. Little did I know that meant an MUA (Manipulation Under Anesthesia). Can you imagine the poor PT trying to do PT on a brand new total, and the MUA leg as well? I postponed that second knee. It was also mentioned that he'd go down a half size or so for the next knee. That planted a seed of doubt if that too was contributing to the fact I couldn't bend much more than 90* still at that point! I still couldn't flatten my leg either. The PT had said she'd see one way or the other, not both issues! So many variables.

I had to start all over again with daily PT after that manipulation, then reducing to 3x/week... 2x/wk and finally ta-da! Over a year and a half later, it finally started to work pretty good. I have to stretch daily, ride my upright bicycle and do floor exercises to get her moving. I can achieve 125* and 0*. I recently sent my PT a short video of me hiking up a mountain at Glacier National Park. She helped me get there!

Now with this sudden terrible bone-on-bone stuff showing up, I gotta figure something out. There's life to be led. Love my NSAIDS and ice machine right now. Today is so much better than yesterday after icing all night. But there is the inevitable mountain to still climb for real.

I will take your suggestions, study, slow down and make a plan.

Nevertheless... there's a country on fire and our health benefits may be out the door in the future? Who knows. Lots to consider