What is the best hyaluronic acid brand or type fo knee in?

I'm not sure there is compelling evidence that one form of hyaluronic acid is any better than another, if only because no one seems to have pinned down what makes HA work in some patients but not in others in the first place. As a result, it's hard to compare clinical trials of forms of HA, since you don't know whether the difference is in the drug or the trial participants. (Totally aside from different trial protocols and sizes.) Here's an excellent set of guidelines for non-surgical OA solutions to explore: https://journals.lww.com/jaaos/fulltext/2022/05010/aaos_clinical_practice_guideline_summary_.10.aspx.

I'm 73 and am bone-on-bone in my left knee, with a complicated back story (as most of us have). My goal is to avoid a TKA forever if I can maintain my quality of life without it -- the fraction of people who have poor results is too high for my taste, and a good recovery will probably require me to sleep on my back, which I can't do without drugs that would be difficult to wean myself off of. Corticosteroids scare me, due to their potential for damage. I've posted before about the fact that I've bought a lot of time with weight loss (bariatric surgery, and subsequently GLP-1RA), gait retraining, and PT. (Can't do NSAIDs or equivalent re: bariatric surgery.) Dietary supplements have been useless for me, although like HA, they work for some people but not others.

I am one of the people hyaluronic acid works for, which requires you to try it to find out. I've found that HA can be defeated behaviorally -- in other words, you need to combine it with some level of gentle exercise (aquatic PT is great for this, or even just a reasonable amount of frequent walking around the house) without provoking it with lots of stairs, carrying heavy weights, or trying to exercise through the pain (eg, squats and lunges). If you don't baby the knee during and for several weeks after the injection period, you don't give it time to help heal the inflammation.

My next step is likely to be platelet-rich plasma, but I'd like to push that off if I can until best practices for plasma prep have been identified, which is not currently the case.

In regard to TKA vs partial, I've looked into that, and the success of a partial very much seems to depend on exactly where your problem lies in the knee, and the source of the problem (OA vs traumatic damage, for example). You definitely want a surgeon with experience doing a partial, so anyone who recommends against it because most of their work is with TKAs is not the right person. I may well be wrong about this, but I have the impression that surgeons in Europe are more open to and experienced with partials, while they are less common in the US.

@laughlin1947 some people have success with PPR but insurance doesn’t cover it