Review ArticlesTreatment of OA of the Knee in the Middle-aged Athlete: The Role of ArthroscopyKrych, Aaron J. MD*; Bert, Jack M. MD†; Levy, Bruce A. MD*Author Information *Department of Orthopedics, Mayo Clinic, Rochester †Department of Orthopedic Surgery, University of Minnesota School of Medicine, Minneapolis, MN Disclosure: B.A.L. is a consultant for and receives royalties from Arthrex. He receives research support from Arthrex and Biomet. The remaining authors declare no conflict of interest. Reprints: Bruce A. Levy, MD, Department of Orthopedics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Sports Medicine and Arthroscopy Review: March 2013 - Volume 21 - Issue 1 - p 23-30 doi: 10.1097/JSA.0b013e318270d1bd Buy Metrics Abstract Knee arthroscopy for patients with osteoarthritis remains controversial. The outcome of arthroscopic debridement in a patient with symptomatic arthritis, and in the absence of mechanical symptoms, is inconsistent and short lived. However, in carefully selected patients with mild or moderate arthritis on standing radiographs, with the acute onset of symptoms, well-localized joint line pain, and painful mechanical symptoms, improved knee function can be expected. Regardless, the natural history of the disease process is unaltered. Patients, especially higher demand middle-aged athletes, must be counseled about the prognosis of degenerative arthritis, the limited positive effects of the arthroscopic procedure, the potential for complications, and the probable need for reconstructive surgery in the future. © 2013 Lippincott Williams & Wilkins, Inc.