How are you but it does sound as if you are pretty active. There are not a whole lot of options, but if you were getting some relief from the hyaluronic acid injections, I would continue on with them. You do have some health issues to consider so having surgery might not be the best option, but speak to your doctor to see how you feel about your proposed prognosis. They successfully deal with people who have all sorts of health conditions going into surgery. If you need.to lose weight I encourage you to do so as it does help lighten the load on your knee