bean11,
I had my right patella removed back in 1979, total arthritic disentegration. I had two of the best orthopedic surgeons in the country , Dr. Hobbs and San Diego Chargers team orthopedic, Dr. Woodward, perform their magic on me. I was the 8th person in the U.S. NOT to have heavy bandaging/brace after surgery and was not permitted to use any form of cane/crutch or walker. A simple gauze pad over the 100 odd stitches and a ace wrap was it. Started physical therapy 4 days after, 4 times a week/2hrs per. In 7 months I could squat down like a catcher in baseball and rise, which surprised both DRs. THE ONLY WAY IT WAS POSSIBLE WAS INTENSE PHYSICAL THERAPY.
Looking at your x-ray, and I'm no doctor, I would suggest looking into full knee replacement surgery. Removing just the patella is the most serious surgery to recover from, wheras replacement surgery has become less intrusive and although physical therapy is a must, the muscles aren't cut and re-attached making the therapy less painful, and shorter.
I'm now 59, still play golf 3 times a week, ride the bicycle, and if a few beers have been consumed, water skiid(not up for long, but sking)
Good Luck with you knee,
SANTEESLIM