Philosophically, I totally agree with you. However, I let the NHS in England take a crack at it when I initially injured it. They performed a single normal X-ray, said "It's not broken; have a nice life!", with no other care suggestions than strapping it up, and this was when I couldn't walk on it for more than 2 minutes for 2 weeks, and the knee was swollen to twice its normal size.

In this instance, it's not a class implication about "any old surgeon" - it's a competency statement. I've heard too many horror stories about crap knee surgery, and I'm pretty skittish about the idea in general. I know this guy is da bomb; if he worked in the public sector, I'd be doing it that way. I totally agree that it's fucked that you can't get access to the best surgeons publically (or perhaps you can, but it wasn't presented as an option).

And yes, I don't want to let this go for another year (or two) - three years is enough. Since it has already gone downhill, having it get worse is not an appealing thought, as you say. :-(