Not all knee injuries and painful conditions require, or are amenable, to arthroscopic surgery.

Knee injuries such as isolated medial collateral ligament injury can be managed successfully with bracing and physiotherapy without requiring surgery. Anterior cruciate ligament injuries, in the appropriate setting, and particularly in the older age group, may be managed successfully non-operatively.

Arthroscopic treatment for osteoarthritic knee (age-related wear and degeneration of the articular cartilage) is less predictable than arthroscopic surgery for damage of articular cartilages of the young person

Commonly with chronic meniscus tears a cyst develops in the back of the knee known as a Baker’s cyst. Treatment is usually either the cleaning up of the damaged meniscus, or repairing the torn meniscus, resulting in resolving the cyst. Occasionally, very thick walled cysts require surgical removal through a separate incision in the back of the knee.

There is current controversy as to the benefit of arthroscopic surgery for an arthritic knee. Recent studies show similar beneficial results comparing knee arthroscopy to non-operative treatments such as physiotherapy.

It is advisable to have physiotherapy for many knee conditions prior to surgical treatment, particularly once a correct diagnosis is established through history, examination and appropriate investigations such as plain x-rays and MRI scan. A reasonable period of physiotherapy is required to see whether non-operative treatment results in adequate positive outcomes. Losing weight in overweight people is often beneficial for many knee conditions