A million Americans get this knee surgery every year. But does it work?
Each year, Americans undergo approximately 1 million surgeries to repair tears in the meniscus — a C-shaped piece of cartilage that acts like a shock absorber inside the knee, cushioning the thigh bone from the shinbone. During the procedure, known as an arthroscopic partial meniscectomy, surgeons insert small instruments into the knee joint and trim away damaged portions of the meniscus. It has become one of the most common orthopedic procedures in the U.S.
But a new long-term study found no significant differences in pain, knee function or quality of life between patients who underwent the surgery and those who received a placebo procedure.
The findings add to a growing body of evidence suggesting the surgery may provide little benefit for many middle-aged and older adults with age-related meniscus tears and may even carry a greater risk of future joint damage and additional surgeries such as knee replacement.
“Our findings suggest that this may be an example of what is known as a medical reversal, where broadly used therapy proves ineffective or even harmful,” Teppo Järvinen, the orthopedic surgeon who led the study, said.
What the researchers found
Researchers in Finland and Sweden conducted a randomized controlled trial involving 146 patients with degenerative meniscus tears but little or no evidence of arthritis on X-rays. Participants were randomly assigned to either undergo meniscus repair surgery or a placebo procedure. Patients did not know which procedure they received.
The researchers then followed participants for 10 years, tracking pain levels, knee function, arthritis progression and whether patients later required additional knee procedures. More than 90% of patients completed the decade-long follow-up.
At the end of the study period, patients who underwent the real surgery did not report better outcomes than those in the placebo group. Researchers also found signs that surgery may have worsened long-term joint health. About 81% of patients in the surgery group showed progression of knee osteoarthritis on imaging scans, compared with 70% of patients in the sham-surgery group. Patients who underwent the real surgery were also somewhat more likely to later require knee replacement or other major knee procedures.
The study focused specifically on middle-aged and older adults with degenerative meniscus tears and may not apply to younger patients or people who tear their meniscus during sports or other traumatic injuries.
Years of mounting evidence
The new study adds to a growing body of research questioning the benefit of meniscus surgery.
A 2013 study that also randomly assigned patients, aged 35 to 65, to undergo the actual procedure or a placebo found that while both groups improved one year out, there were no significant differences in pain relief or knee function between the groups. A follow-up analysis found similar results after two years, with no clear evidence that surgery provided meaningful long-term benefits even among patients reporting mechanical symptoms such as knee catching or locking.
A 2015 review of multiple clinical trials found little evidence that arthroscopic surgery for degenerative knee disease improved long-term pain or function compared with non-surgical approaches such as physical therapy and exercise.
Observational studies have also raised concerns about potential harms. Some research has suggested that patients who undergo meniscus removal may face a greater likelihood of later knee replacement surgery, though observational studies cannot definitively prove that the surgery itself caused those outcomes because patients receiving surgery may already have had more severe joint problems.
Taken together, the evidence increasingly suggests that meniscus surgery may offer limited long-term benefit for some patients. But important questions about who specifically might still benefit from surgery remain unresolved.
Round out your reading
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Ella Rae Greene, Editor In Chief
