In my day job, I'm a GP.

I advocate a VERY conservative approach to orthopaedic surgery, because (1)most people fail to realise that a lot of orthopaedic surgery at this level involves taking stuff out you can never put back and (2) the natural history of these type of injuries is that they mostly do get better eventually.

Also, after an arthroscopy +/- trimming/ fiddling you may not be able to run etc(and certainly not for several weeks or months initially)

Another vote for physio, with exercise modification(not cessation!)

Anecdotally, a lot of cartilage injuries do 'wear smooth again'. Even complete tears of ACL etc are not incompatible with sport