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How important is running

Keith (in green hoops) just ahead of me in a 3000m race in
Hamilton, NZ, in January 1979.

I have a long-time friend, Keith, who was a talented runner in his prime and with whom I have run many miles over the past forty years.  He has struggled with a knee problem over the last decade that has severely limited his ability to run, and despite doing some swimming and cycling for fitness, is desperate to get back to running.  Like me, running has played such a large part in his life and self-perception, that its absence really is depressing.

Keith has tried arthroscopy and various other treatments, and can walk without significant problems, but misses his running so much that he has booked in for a partial knee replacement next week.  If you Google "running with a partial knee replacement", you can find instances of runners doing so successfully.  You can also find a study that suggests no difference in knee replacement failure rates after seven years between two groups, one of whom exercised more vigorously than advised by their surgeons.  However, I couldn't find any website where doctors recommended running, especially long-distance running, after a partial or total knee replacement.

Partial and total knee replacement diagram
[Source:  Wikipedia]

I'm concerned for the welfare of my friend.  Although I understand completely what is driving him to have this surgery, I fear that his post-op resumption of running will risk failure of the joint replacement and maybe even leave him worse off than at present.  However, I also know that I don't know what I would do in the same situation.  Given that I hope to keep running for many years to come and already have one knee with problems, I suspect I will find out at some point.  In the meantime, I have my fingers crossed for a successful surgical outcome for Keith, and do hope he can realise his ambition to resume running.