I am an 81 YO male. My right knee malfunctioned at the beginning of 2025 and I became severely misaligned with a nerve impingement resulting therefrom.

I had previously done a ton of research and found a great hip/knee replacement surgeon who replaced my left hip five years ago. So I already Had an extraordinary surgeon. We tried some non surgical methods (such as a cortisone shot in the knee) but they didn't work. So we scheduled the right knee replacement.

One of the things I wanted was a bicruciate retaining implant (BCR). My ACL appeared to be strong and I saw no reason to remove it if it still worked. The surgeon I had selected for my left hip is one of the very few who has been doing the BCRs for a long time (a decade). I was not afraid of the surgery but I was of general anesthesia so I made sure that it was done with a regional.

My surgeon did a mid vastus procedure (minimally invasive); did not use a tourniquet; used a robotic assistant (CORI); put in a BCR; fixed my severe valgus misalignment with a Functional alignment; and did a plastic surgery close.

A few days before my surgery I met with my surgeon and told him that I wanted to be back on the golf course by the end of the fourth week. he replied that it was an aggressive target but he was up for the challenge if I was. He was. I was. On the 27th day after my right knee replacement, I was playing golf (my surgeon's PA had cleared me to resume driving after one week). I had an RX for oxycodone which I filled but I still have the bottle which remains unopened. I had zero post surgery pain.

I believe that the traditional standard still should apply. Assume you will have pain, meaningful pain for a number of months (semi worst case). Is your current pain and discomfort such that it is interfering with your enjoyment of life and the ability to do what you want to do? If yes...then I believe you are ready. If no, you probably should wait.

As @covidstinks2023 said, IMHO once you decide to proceed surgeon selection is the single most critical decision you will make. There are many hip/knee surgeons. Like all professions, some are extraordinary, some are terrible and most are somewhere in the middle. Find that extraordinary surgeon and you will have maximized your chance at a pain free or pain minimized recovery and a great after life. I did. At my six month checkup my surgeon told me I had no limitations. I asked him if that meant I could go on trampolines with my grandkids; he said yes. I asked if that meant I could run; he said if I wanted to. Yesterday I went walking in the mall; I did four miles.