I’m 52 now; was 48 when my left knee (which had always been my good one) started hurting during an easy run. I laid off running for several weeks, but it never improved, so I went to a knee doc to see what was wrong. They took xrays and were shocked I wasn’t there for my right knee, which had always been my problem knee but for whatever reason wasn’t hurting when I went in. Long story short: both of my kneecaps are in the wrong place, way too far to the outside. Over time, because I’ve run my whole life, I’ve worn away the cartilage behind both kneecaps. I will eventually need to have both knees replaced. The right knee looks horrible on x-rays and has been problematic for me since I first hurt it skiing in 1988, but for reasons unknown to any of the knee docs I’ve seen, it’s generally behaving itself. It was the left knee that would swell mercilessly whenever I did anything that stressed the kneecap, was hurting me constantly, and was the reason I was seeking out help from knee docs.
In 2012, after I realized that rooster comb goop didn’t work and that cortisone injections I was getting were having very little positive effect, I sought out different surgical opinions for my left knee. One knee surgeon told me I had no options. Another knee surgeon offered me a partial knee replacement (patello femoral and medial compartments) and told me I’d be back running in six months. I went back to the first knee surgeon and told him another knee surgeon had offered me a partial knee replacement. When he heard that, he offered me a tibial tubercle osteotomy. He told me it would require an incredibly long recovery, but that it might delay my need for a knee replacement. I did a lot of research and ultimately went for the osteotomy in July of 2013. He called it salvage surgery and told me I should never, EVER run again. Before my surgery, both swimming and cycling hurt a ton; walking on flat surfaces was okay, but any downhill incline was horribly painful, and forget about stairs, either up or down. I told him I wanted to be able to swim and bike hard (albeit on flats, not hills), and that I understood my running days were behind me. He said I’d be able to after I completely recovered.
I was religious about my recovery from the osteotomy, and I’ve been thrilled with the results. To be clear, I cannot swim hard anymore; kicking kills my knees, as does pushing off the wall with anything more than a very light touch. So, I’m slower on the swim, but I can still swim; I use a sort of modified pull. I cannot ride hills without paying for it for many days. For that reason, it’s just easier to stick to flat and rolling terrain. But, I can still ride long, and I can still ride hard. I can walk long distances (though sometimes my right knee will get very upset when I do). I can even shuffle (no one who has ever run would call it running, but it is not walking; it’s sort of a cross between a shuffle and a jog). I swear by my Hokas. I still compete (though many on this forum would call it participation and not competition; the point is, I still race, even though I’m a lot slower than I used to be; I just love competition too much to not do it).
So yeah, I found relief from a similar diagnosis. Are your running days over? I hate to say so, but yes, if we’re talking about actual running, they probably are. Do you have to live a sedentary lifestyle? Hell no! I was miserable and in a lot of pain after a knee surgeon told me I had no other options. A friend set me straight and convinced me to seek out a second opinion. That led to several different consultations, which eventually led to an osteotomy, which eventually led to a LOT less knee pain. I think the key is that you can’t go into a knee surgeon’s office and say “I’m an ultra runner, my knee hurts, can you fix me?” You have to go into a knee surgeon’s office and say, “I am an active person whose lifestyle is being significantly curtailed by my knee pain. I’m coming to you asking for a way to return to being active, without constant pain. Can you help me?”
Standing for me is a no-no as well. That might be why I have PF on the left, from putting my weight on it when I do stand for too long.