This is Dr. David
2 years ago is a along time to have a knee injury.
it sounds like this is a bad tear of the cartilage of the knee
I'm glad she is doing physical therapy.
a knee steroid injection could help decrease pain and inflammation (has she had one yet)?
she may benefit from protein rich plasma injection into the knee to help with healing, but there is controversy with this.
she can try to take glucosamine and condroitin and tumeric and bromaline to help decrease inflammation in the knee.
you are right, orthoscopic knee surgery is the last resort, but it sounds like she has been trying other options for 2 years now
if nothing seems to be helping, she may have to have knee surgery.
every patient is different and have different results to orthosopic knee surgery.
at least she is not facing to have to do a total knee replacement at this point.
let me know if you have questions.