I'm 32 and mri says i hve loss of cartilage and bone on bone due to severe arthritis will i need a osteotomy ? or knee replacement

TKA vs osteotomy: Both are options. Depends upon experience of your surgeon, other compartment involvement, ligament stability, alignment.

Stay away from TKA: At 32, a total knee replacement is ill-advised. If you have wear in one compartment only, we generally recommend joint sparing procedures such as an osteotomy, or cartilage restoration procedures.