Anyway, long story short, it was his opinion (and the opinion of my Personal Physician's Assistant, who accompanied me) that the best solution is to scope it.
Specifically, arthroscopic surgery. At a minimum, he will go in there and clean it up. He said there is plenty on my MRI to clean up, from torn meniscus, bone spurs, a bursa cyst, loose cartilage, and all kinds of fun stuff. They both think that a cleanup could improve my knee and make me feel better.
While he's in there, he'll check to see if I'm a candidate for microfracture, and if so he'll do that. He'll also hopefully (if possible) harvest some cartilage to be regrown and reattached later if I need/want it. Those things sound pretty cool and high-tech!
A basic cleanup would be a pretty quick recovery time, only 3 or 4 days on crutches, around a month total recovery. The bummer is that if he does the microfracture thing, I'd need to be on crutches for 4 to 6 weeks. If he doesn't do that, it's a different kind of bummer because it kind of sounds like it'd be the surgery with the highest chance of significant improvement. So I don't know what to hope for. I don't really get to choose; he'll decide once he's in there and looks around. The weird thing is I won't know until after the surgery, which I'll end up with.
So it's not scheduled yet, but I think if I'm going to do it, I should try to get it over with quickly -- like early May. The sooner I can get recovered and start having fun with my summer, the better. Presuming I don't chicken out, I'll call tomorrow and see what days are available to me.