As a veteran of 3 micro-fractures in a year
, while I was in HS nonetheless, my Ortho always said I'd be facing a knee replacement in the future.
That being said in my follow-ups with him over the years my knees still swell, ache and sometimes have significant pain. He's always advised that he can go in there and clear stuff out, but there isn't much surgically he can do for me. Since every time I've been in for a 'simple' knee scope things haven't gone according to plan and I end up being on crutches for 3+ months I'm in no hurry to go back under the knife and short of a debilitating type of pain/injury my surgeon won't encourage it either.
So to answer your question I have had my Ortho talk me out of surgery, but I also know that short of a significant injury where I can't move my knee at all there is minimal they can do for me....
So always I listen to my body. Don't work more than 3 games in a day and try to push it beyond my limits. Plus a healthy dose of stretching, ice and Aleve have allowed me to ref probably over 2000 + games in the 14+ years I've been doing this.