Hi @ecook! I am 52 and had to have my right knee replaced in May and now need to have the left knee replaced. I can tell you what my situation is. I was diagnosed with osteoarthritis in 2009 and I had a cortisone shot then. My knees were often stiff and sore, but I kept going. In February of 2018, my right knee began to lock up and was painful. It was at that point that I went to go see about the orthovisc shot. The doctor compared my x-ray to the one from 2009. I had no cartilige left and was bone on bone. At that time I told them I wanted the shot and there was no way I was going to have a TKR. They tried for months to get the shot approved. I finally got to a point where my knee was locking up constantly and at one point was walking from a restaurant to my car and it locked up so bad that a friend had to drag me to the car. It was then that I realized that I had no other options. When I went to see the doctor, he told me the same thing. I was at a point where the shots would no longer work and a TKR was my only option. I went to the doctor on May 2 and had the surgery on May 14. Normally there is a 3 month wait, but My right knee was severe. My left knee was not in great shape either and the shots won't help. So I need to schedule that surgery. If the doctor says the shots will help, then I would take the shots and hold off as long as I could. They will let you know when the shots wont work. Because of my age, I will have to have both knees done again at some point. If you have other options, I would consider them. See what some of the others in this group suggest. Good luck to you. Let us know what you decide.