Numerous studies have shown that arthroscopic surgery for a degenerative knee does not result in long-term improvement (> 2 years). However, it continues to remain a very common procedure and even more commonly performed on patients with worker’s compensation claims since they wrongly assume that an “injury” caused the problem and can be corrected when in fact, the “injury” may have triggered SYMPTOMS of a pre-existing problem. In this situation, even if the treatment is related to the injury, the treating physician MUST provide accurate information that reflects the degenerative process and consider other alternative treatments. All degenerative knees have been shown to have chronic, long-standing meniscus tears on MRI. Unlike acute tears in a non-degenerative knee that quickly responds to surgery, and should not be treated with physical therapy, meniscus tears in a significantly degenerative knee should not be treated with arthroscopic surgery. This article, a large review of the published literature, recently published in the British Journal of Sport and Exercise supports this observation.