Compared with conservative treatment, arthroscopy did not decrease or delay total knee arthroplasty (TKA) in a 5-year retrospective study of 382 patients with osteoarthritis (OA). Of the 214 patients treated with arthroscopy, 32 (15%) eventually underwent TKA, compared with 30 of the 168 patients (17.9%) treated conservatively (P = 0.20). WOMAC scores were lower in the arthroscopy group than in the conservative group at 1 year and 2 years, indicating that arthroscopy provided greater relief of knee OA symptoms at these time points.