The high incidence of knee osteoarthritis (OA) seriously affects the lives of older adults and is one of the major causes of physical disability. Knee OA treatment modalities include non-surgical and surgical treatments. Non-surgical treatment includes NASIDs drugs, joint cavity injections, and physical therapy. Surgical treatment is considered when non-surgical treatment is not effective. Surgical treatment includes arthroscopic surgery and open surgery, such as joint cleanup, microfracture, autologous chondrocyte transplantation, autologous or allogeneic osteochondral transplantation, and total knee replacement. Arthroscopic cleanup has become the treatment of choice for patients aged 45-65 years with early knee OA due to less trauma, faster recovery, and lower surgical costs, and it includes joint lavage, chondroplasty (cartilage damage surface smoothing, removal of unstable cartilage), free body removal, meniscectomy, and synovectomy. One study evaluated the efficacy of arthroscopic debridement in the treatment of grade III-IV cartilage injuries in the elderly knee and found that the mean postoperative satisfaction score was 73 in 39 patients undergoing knee surgery at 34 months of follow-up.Ibarra et al, in a follow-up of 39 (6 lost) patients with knee OA after arthroscopic lavage and debridement, found that 93% of patients (31/33) were satisfied with the outcome , 25 of whom Of these patients, 25 had grade II-III cartilage damage and 6 had grade IV cartilage damage. Meta-analysis studies have found that a variety of factors can influence the outcome of the procedure, including imaging OA grade and individual patient factors (e.g., disease duration, age, weight). In a cross-sectional study conducted by Aaron et al, a total of 122 patients with knee OA underwent arthroplasty. 110 patients were followed up for a mean of 34 months and found that 58 patients with mild arthritis, normal force lines, and joint space width ≥3 mm had improved symptoms in 52 (90%) of the patients after surgery, whereas only 5 of 20 patients with severe arthritis, poor force lines, and joint space width <2 mm (25 Jackson et al [5] showed similar results; their mid-term follow-up found a 90.6% excellent postoperative rate in patients with knee OA grade II, but only 48.7% and 11.9% in patients with knee OA grades III and IV. This shows that joint debridement is not effective in all patients with knee OA, and it is important to select the right case. In conclusion, although the final outcome and natural degenerative process of knee OA is not altered or reversed, arthroscopic debridement is still a reliable and effective treatment modality in reducing knee pain and improving function with proper case selection.