how do I know this is the best option?

I think about this question from time to time. Why am I willing to undergo this major procedure and invasion of my body when I can still walk around?

Friends who know my plans for the knee replacement immediately want to help me, push me in a wheelchair, sit down with me or stay home. There is surprise among some that I am not showing outward signs of the pain or the crippled up stature of a person with a failed knee.

I have been tending to this knee and modifying my life around it for the last 3 years, 5 years, even 10 years when I gave up running. I'm ready to plan around another priority.

This is what I've been doing to keep the knee functioning: the first thing was a knee arthroscopy about 10 years ago. The doctor trimmed the cartilage which had gotten torn by my arthritic knee. His mantra was "motion is lotion" so I returned to my spin class about 1 week after that procedure. It was not a big deal. I think I used a cane for a few days and then was good. I had the procedure repeated several years later when I could not run for the bus. I never run for the bus now. I don't run to cross a street in front of a turning car. I don't run for anything because I know the payment will be high in terms of pain.

For some reason, riding my bike has been an activity that I have been able to continue to do. I think it has something to do with being clipped into pedals which keep my knee aligned directly over my foot. This is one accommodation I have made when doing any exercise. It seems keeping the alignment keeps the range of motion open. When alignment is not there, I hear the clunk, clunk, clunk of the bone on bone when I bend into a yoga pose for instance. I learned on a recent week in Wisconsin that this does not work when putting the knee under resistance. I was resigned to riding the flat roads in beautiful, hilly, southern WI to keep the pain to a manageable level and this was especially important when we had plays to sit through in the evening. Any activity that puts any extra stress on the knee requires significant icing when the activity is over.

Over the last few years I have been working on building strength in the leg so that it can support the faulty knee. I think of all the things I've done, this has been the most helpful. Walking can be painful and Eric told me I was starting to walk with a limp. I worked hard to walk without the limp, not sure if I succeeded but he didn't mention it again, and this had to do with hip and glut strength, quad strength, hip flexibility, focus on balance and stride. Much of this work has been done with yoga (thanks to my wonderful instructors) which I love for its ability to work with a body where it is and help it extend into areas that are less accessible. My most recent foray into strengthening is a concerted effort to be in the best possible shape as I approach this surgery with the assumption that I will come through it strong if I go in strong. I am working with a fabulous personal trainer on using my body weight resistance through pilates and other methods to strengthen core, upper body and legs where I can without putting the knee under pressure

This post is going on too long because this is a passionate topic for me.