As my ex turns 60 today, I fully agree surgery should be the LAST resort.
He told me Thursday night, he needs to get his shoulder replaced. 6 weeks of passive PT, 6 months of active PT. Due to scuba bubbles. Will be getting a couple more MRIs to look for more dead bone, most likely in hips. Then would need a hip replacement.
He did the double knee replacements 5 years ago. Due to rock climbing and skiing. AND being over 100+lbs too heavy. Has been whining how he has blown/worn out the "pads" on the artificial knees for the last 6 months.
The only thing I can add on the ankle joint is, LOSE WEIGHT, as every couple of pounds lost (if this is even a minor issue) improves the outcome on any weight bearing joint problem.