Treatment depends on your symptoms rather than the MRI alone. Initially, I recommend weight reduction (if overweight), activity modification, supervised quadriceps (especially VMO) and hip abductor strengthening, patellar stabilization exercises, NSAIDs if medically suitable, and vitamin D optimization if deficient. If pain persists despite 8–12 weeks of conservative treatment, consult a knee specialist to discuss options such as injections (PRP/viscosupplementation in selected patients) or arthroscopic evaluation only when clinically indicated.

Avoid deep squats, kneeling, stair overuse, and prolonged sitting with bent knees. Maintaining a healthy body weight and continuing regular low-impact exercises such as cycling or swimming can significantly reduce symptoms and help slow further cartilage degeneration.