@ashpen Hello and welcome. I would imagine your orthopedic doctor took x-rays first then sent you to physical therapy for strengthening. PT is a beginner step to see if it can help enough. I'm sorry it hasn't provided the relief you hoped for.
You mentioned you are always doing a lot and have noticed change in your body over the past two years….your knee must be giving you the business for it. It's hard to slow down, but always best to listen to our bodies without pushing.
Are you seeing your orthopedic doctor again on the 15th? Perhaps an MRI is in order.
Do you mind letting me know the outcome of your upcoming appointment?