Very thoughtful post Sherry. A few comments:

1. This isn't scientific, but my opinion is that most people who post here have had problems, some inevitable and unfortunately, others avoidable if only the patient took their part in recovery seriously. Once a decision is made to have a TKR, find a trainer or pt and do as much pre surgery rehab as possible to make the muscles around the knee strong. Post surgery do ALL the recommended exercises, usually 3x day and usually immediately after surgery.

2. If you aren't having significant and constant pain, wait. I started pre hab exercises and my knee got better. I put off surgery until the day I jammed the lateral side of my knee and swelling commenced and the pain would not go away. And the pain kept me up at night. That's when I decided to have surgery.

3. Putting this all together, you want to eventually come out of surgery feeling better, Ala, no pain or much less pain. If there is no pain at the moment, hold off. My surgeon recommended this, saying he doesn't want people coming back feeling worse than before the surgery.

4. Chances are very good that with bone on bone, you need a TKR. That said, only do it when the pain is constant. Cortisone will make it feel better, but it's a band aid. And you can't have surgery within 3 months of a cortisone shot.

5. Finally, and I've posted this often, do exercises pre surgery to strengthen the quads and hamstring muscles. And literally attack the post-op rehab (well, don't over do it, but you get my meaning). They will have you take a short walk while you are still in the recovery room. Activity is your friend now. Do all the ankle pulls and leg lifts and what not, probably 3x day, and see a pt asap after surgery. The results should be good with a bit of patience. No one feels great after a surgery like this, but each day gets a little better.

I had both knees replaced in 2022. I'm a 68 y/o male and former runner. Now I'm in the gym 6 or 7 days a week, work with a trainer 2x week, and have never felt better. Now I practiced what I preached and never gave scar tissue a chance!

As for surgeons, find someone in their mid 30s to mid/late 40s, with a solid pedigree (university or residency or both) and who use a robotic assistant, like the Stryker Mako.

Scar tissue is the biggest threat to a recovery. I've seen too many people post here who neglected the post op rehab or thought they could do it later or at their leisure. First thought wrong! Keep that knee moving as much and as far as it will allow. Get obsessed with your recovery!

All the best to you!