Synvisc and Celebrex helped me while I still had some cartilage. Bought me about 5 years. Altho I still had pain. I had TKA of first knee in July and the other 4 weeks ago. I wanted to put this behind me as quickly as possible and minimize my deductible. Both knees were bone on bone. You probably know that when OA is this advanced the bones develop "spurs" and other problems with shape and function. This can cause more pain, gait problems, etc. It really must be addressed to ensure "being in great shape, very active, and able to work as long as you would like". I investigated PRP and stem cells before my surgeries. Unfortunately, they are not at the stage of having good clinical studies yet. Both my husband and I have worked in health care all our careers and just couldn't accept a treatment without good research behind it. If you feel that you can wait another 4-5 years the jury will probably be in. In the shorter run it is a gamble as to efficacy. You probably know it is not covered by insurance and is quite expensive ( I was quoted about $11K for both knees). Please do your due diligence if you go this route as there are many poorly trained practitioners out there offering it as it is very lucrative for them. I am aware of Mayo clinic starting some studies. Regennex is company that trains well and seems to be a leader in the field. They also have some tracking/result reporting which is certainly better than most. My local clinic only offered anecdotal reporting which is pretty worthless.
The bone cutting should be the least of your worries. This surgery has really been perfected over the years and generally people have excellent results.
Most of the "cutting" is getting rid of the problems I alluded to above. Find a surgeon with a good history who does lots of knees. I waited three months to have the best ortho in my area do my surgery. The surgery takes less than an hour. I was shocked that I had no post surgical pain with first knee. They give you lots of non narcotic meds now. I did have some pain with the second, probably because I wasn't expecting any and didn't take anything till it was bad. That was a problem for just a few days.
Yes you have to "deal with" therapy. You actually do most of the exercise yourself at home. Since you are in great shape you most likely already commit time to exercise. Depending on your job, you could probably go back full time at a month. I was seated a lot of time and could go back at 4 weeks. It would be easy to work from home if that is an option. Scars are scars — better than pain. They fade a lot over time. Mine are 6 inches long (again great strides have been made perfecting this surgery.)
So, just my lengthy 2 cents worth from someone whose been there recently. Hope you find the course that works for you. All the best. Kay 62yo
PS: Walking on artificial knee ( at 10-12 weeks post replacement ) felt the same as my natural knee without the pain of arthritis.