Each of us sets our own criteria for when to get TKR, of course. For me, I decided that I was going to go ahead in 2025 when my knee pain started interfering with my sleep at night and that I was starting to avoid walking down stairs in addition to limiting other activities. I was willing to accept the risks at that point. Sleep interference and avoiding activities is still my own personal threshold for going ahead with TKR, but others live with that a long time before going through with TKR.

But when I went to schedule the procedure my surgeon told me about HA knee injections and that his uncle had put off TKR another 5 years by getting the injections. My years-outdated information was only about steroid knee injections which I had decided against in the past. My first set of HA injections was amazing - like getting my old knee back. But by the second set the benefit was already more muted.

Reading people's challenges on this site has been very helpful. Some small percentage of us will not have a good outcome for TKR. Some people who had a great first TKR are reporting issues with the second knee. If a year after TKR my knee is not as good as before the surgery, then will I feel that I had made the right bet with the information that I had at the time? I will delay knee surgery until I believe that in the face of a bad outcome I can look at myself in the mirror and say "yes, it was the best choice that I could make with what I knew then".

I have significant knee pain often, and my x-rays are bone-on-bone. My downhill skiing is very limited but my cross-country skiing is fine and at night I can always find a comfortable knee position to sleep. So, for now, I enjoy what my knee can do for me and I postpone TKR. If my knee regresses back to sleep interference and/or stair avoidance then then I will get the surgery. If I was 85 as you are, I might think that maybe my natural knee has a good chance to see me out so there is even more reason to postpone.

Not sure if that was helpful, but you asked for opinions!