The landscape in professional athletics continues to evolve as players have extended their careers beyond ages previously considered retirement age. On the recreational side, as the population ages there has been a significant increase in the number of adults who continue to participate in athletics later into life, as evidenced by major spikes in activities such as pickleball, which has been shown to have significant benefits on physical and mental health.1 With the continued participation in sport there is an associated increase in not only acute injuries, such as ACL tears, but also chronic injuries such as cartilage thinning and loss that come with the physiologic changes of aging combined with the increased wear and tear over time with athletic participation.2, 3, 4, 5 Regarding cartilage damage specifically, keeping the aging athlete healthy and able to participate requires a focused and thorough physical exam, proper imaging workup, and shared decision making between the surgeon and athlete on goals of specific activity and level of play. With these aspects in mind, there are a plethora of non-operative and operative interventions available to extend a player's career.