John...I'm no ortho specialist, but I'd have to basically agree with BFM.D. above. I think a repeat MRI is reasonable if it has been this long and he's still having problems, although I wouldn't be surprised if it didn't show anything new. But he's right, if it does show something, then you've got a target. If not, then I also agree that there still might be something that can show up on a scope, and you would need another opinion to see if a scope is indicated. And then you'd have to decide if the risk of the procedure is worth it.
I'm also available by PM if you want.