Typical picture of a degenerative knee. First thing is that treating an MRI shall not suffice, we need to clinically evaluate the patient for exact diagnosis. A standing AP xray would have been of more help than the MR scan. Would recommend treating osteoarthritis conservatively using medications, offloader brace, lifestyle modification and weight reduction. Arthroscopic evaluation would be of significant help only in case of a severly painful acute knee in a locked state due to meniscus tear. Try conservative therapy first as mentioned already. Xrays would be imperative in assessing grade of arthritis.

Your symptoms suggest intrarticular soft issue pathology. Try for 2-3 weeks: 1. Regular knee quadriceps exercises ( static and knee bending). 2. Ice pack application will help 3.Medications like Cartigen DN and Enzomac forte will help.

This age is in grey zone for making decision. As the symptoms are not only due this recent tear but osteoarthritis do contribute for this pain. So in my opinion diagnostic Arthroscopy is the best option in this scenario

he needs to see an arthroscopy orthopaedic surgeon. needs a good examination  will most likely need surgery.