Hi, @katienaturegirl Welcome to Connect.

I have had two TKRs. I had to delay the second one due to other conditions so I did turn to hyaluronic acid injections when cortisone was no longer helping much. Unlike @johnbishop mentioned, I found them very helpful. From what I understand they fill in where you no longer have cushioning in the joint. Of course they do wear out and need to be redone eventually. I presume you are not yet on Medicare since you mention that you don't want to have to face having your knee replaced multiple times. I believe Medicare, and this may be true for other insurers, only allow those injections at six month intervals.

You are smart to have lost some weight and to be exercising. Those both will help with recovery. I had heard that some people do "pre-hab" and when I asked my orthopedic surgeon about that he asked if I was doing anything then. I told him I was water jogging and riding my recumbent bike and he said that basically was prehab! Also, I found that the exercise I did prior to the TKR that had to be postponed, helped my knee to feel much better since the muscles surrounding the knee were strengthened.

Make sure you find the best possible surgeon you can find to do the surgery. That can make a huge difference. Also, ask what kind of knee they use, you might want to do a bit of research on that. For my second TKR, I had a Conformis knee which is custom made for each patient and that helps to assure that the fit is perfect vs an "off the shelf" knee. My surgeon was one of the developers of the Conformis so I felt very comfortable with him. He's in Boston and when I was in his waiting room I discovered that people came great distances to go to him. Before I actually decided to go ahead with the surgery I was seeing an orthopedic doctor locally (southern NH) and she was the doctor who I turned to for injections. You cannot have any of those injections within a certain amount of time prior to the surgery.

Unless you are very young I would doubt that you would need to have a knee replaced a second time. The knees they make now are fairly sturdy. Did your doctor say that you might need to have it multiple times? I guess I never faced that because I was in my 60s for the first TKR and in my early 70s for the second one.

Good luck with your decision. I know that decisions for elective surgeries are not easy to make but you are obviously proceeding very cautiously so I'm sure you will make the right decision. Just don't wait so long that you are really in extreme pain and limping. I think I put my first TKR off for too long and that made rehab more difficult.
JK