The most important thing in choosing a treatment option for osteophytes or osteoarthritis is how the condition has progressed so far after several years of progression. If the symptoms persist after strictly conservative treatment, it is highly likely that surgery will be required, and whether arthroscopic clearance or joint replacement will be evaluated by in-person testing. The key is what are the characteristics of the patient’s current symptoms? If it is predominantly joint entrapment with frequent manifestations of interlocking joints, then arthroscopic surgery may be considered. If it manifests as pain with weight-bearing walking, such as walking up and down stairs or squatting, then the possibility of joint replacement should be considered. Simply put, if the extent of the articular cartilage lesion is relatively small, an arthroscopy should be sufficient, and conversely, joint replacement should be considered. A prudent approach is to prepare for joint replacement at the same time as the arthroscopic procedure, and if the cartilage lesion is found to be relatively large microscopically, change to joint replacement on the spot. This is usually not necessary because experienced surgeons can usually assess the correct treatment plan through a preoperative physical examination and question and answer session. Internationally, arthroscopic debridement of degenerative knee arthritis is basically not done anymore, unless there is a free body. Degenerative arthritis of the knee is very common and highly prevalent, and the treatment is well established. Even though the current science and technology is not perfect, the satisfaction rate for joint replacement surgery in the elderly has been upwards of 95%, and the key is still lack of understanding. It can generally be used for 15-20 years, and the possibility of recurrence or major problems is extremely small. Using the general imported prosthesis, the total cost of treatment 45,000 role, the use of domestic prosthesis to 35,000 role. 45,000 total cost using the United States Johnson & Johnson PFC fixed platform prosthesis, is also the most used prosthesis in the world, prosthesis price 28,000, usually this is good enough. If you use a movable platform, the prosthesis price 34,000. A little better, there is the American Schluterich black crystal prosthesis, 56,000, this theoretical life of 30 years. If economic conditions are limited, you can consider using clinical trials of artificial joint prosthesis. Our hospital has been carrying out experiments on artificial hip and knee joints of several companies in the past two years, with a complete ethical review process, supervised by the State Drug Administration and the Ministry of Health, patients are fully protected by law to participate in the experiments, and the joint materials used in the surgery are free of charge, while some of the costs of inspection and follow-up are reduced, usually only 12-15,000 yuan to complete the replacement of one side of the joint by yourself. We have completed nearly 30 surgeries without adverse events. The joint prostheses for clinical trials are actually just imitations of foreign products by domestic manufacturers. In order to be able to pass the inspection of the State Drug Administration, and because the manufacturers had not really introduced foreign production lines at the time of the experiment, the products for this batch of experiments were commissioned abroad, and there is actually no difference in the process and materials. At the same time, due to the protection of the rights of patients under test by medical law, the manufacturer must be held fully responsible for any adverse events that may arise from the experiment, so the experiment is preceded by an informed consent form that guarantees financial and legal responsibility for the patient and allows the patient to withdraw unconditionally from the experiment. This means that the manufacturer and the hospital must be responsible if there are problems related to the experiment, the patient’s rights are protected, and the State Drug Administration and the Health Bureau and the Ethics Committee are required to inspect and inform the experiment at any time. In addition to the joint prosthesis used for the surgery is free of charge, the relevant pre- and post-operative examinations such as routine blood, liver and kidney function and x-ray are also free of charge, always including the cost of a review up to one year after the surgery, and a transportation allowance of 1000 RMB. Usually we only do one knee at a time, mainly because it is more traumatic to do two knees at a time, which is harder for most elderly people, and it is less convenient to exercise after surgery. Our department does about 150 knee replacements a year, but only 5-6 people do two knees at a time, usually younger and in better health at the patient’s own request. Even for a one-stage replacement of both knees, we routinely use two sets of surgical instruments to reduce the problem of contamination of the instruments due to prolonged surgery time. If you are having a double knee replacement at another hospital, you must be aware of this problem. We usually do not exceed 3 hours for both knees, but for insurance purposes, we use two sets of instruments. Whether or not it is time for joint replacement is ultimately determined by a face-to-face Q&A and examination between the physician and the patient, and in fact depends heavily on the physician’s overall judgment. You may want to consider this.