Chris, My lake partner found your question and I will give you my story. I had a total Biomet Signiture Knee on March 7 2012. I tried over 8 years to find the right over the counter supplement and prescriptions to elongate the time until surgery was the last resort. I am 58 and NOT a shortline skier. I along with 3 others built a dedicated ski lake. I was going to wait until Fall for the surgery, but this last winter things went so painfully downhill that even staying in Florida did not work. Being an engineer, I was waiting on the 'right' procedure. I had a chance to attend a seminar about hip and knee replacments on January. When I heard that after an MRI of the diseased knee area, hip and ankle, Biomet builds a model. They along with the Doctor agree on all the post surgery measurments and alignments. Then the new knee was built. The Doctor brought in an x-ray of their greatest damage of bone on bone, put mine up and said mine was the worst case so far. While on the operating table, specially designed for this procedure, the surgeon has jig that he puts on the upper bone and makes 4 cuts. The lower bone is the same. The two new pieces are installed and measurments checked. I kept complaining about most of the pain on the inside of my new knee. While open, he freed up all the connective tisue since I was going to be very active. After some time, these connective tissues reconnect at the new good position. I showed the Doctor a video of a pull and he did not see a problem post surgery. Physical therapy was very painful but they knew I wanted to go back to the course. At 21 days post op, I had 127 degrees of flexion. To prepare for surgery, while in Florida I rode my bycycle 25 miles a day and when in Indiana 30 minutes on my eliptical. Here is a link: http://www.biomet.com/orthopedics/productDetail.cfm?category=2&product=242