Grade IV + Bakers Cyst + Other Arthritis

I believe I may be grade lV. What are the differences between the grades other than four obvioulsy being worse than three? I have heard mostly negative about the SYNVISC injections - not much help. Here in Germany they are quite expensive as well. I'd be curious as to what the doctors propose in your case.

I've been dealing with severe pain in my left knee due to severe osteoarthritis, avascular necrosis, torn cartilege, and sports injuries for many years. About 3 years ago the pain became much worse and I had arthroscopic surgery just to trim up a small tear in the meniscus.

After that surgery, the pain actually worsened and I was diagnosed with Avascular Necrosis in that knee. I've been battling that and getting (minimal) treatment for that for the past 2 1/2 years.

Apparently, all the limping from one leg to the other, has exacerbated the pre-existing factors for chondromalacia patella in my, "good" knee.

I'm already at grade IV chondromalacia of the "trochlea groove" with a Bakers cyst, joint effusion, synovitis, and additional grade III damage in the medial aspect of something. (sorry, can't fully remember the MRI terminology.)

I am floored by the amount of pain I am in. It doesn't help that I'm already having pain in the other knee that is not being releived, but... the pain in my "good" knee is killing me.

I've read a lot on this board about treatments, but they all seem to apply to grade I, II, and some grade III situations.

If I'm already at grade IV, throughout the groove, and on the back of the patella... is there hope? Will I ever return to any level of athletic activity? Or should I just put a down payment on my old lady scooter?