A 10-year study has found that a common knee surgery for meniscus tears does not benefit patients and may lead to worse outcomes. The research, published in the New England Journal of Medicine, compared patients who underwent partial meniscectomy with those who received sham surgery.
Patients who had the surgery scored worse on measures of knee function, pain, and osteoarthritis progression after a decade. Lead author Prof Teppo Järvinen of the University of Helsinki described the findings as a potential 'medical reversal', where a widely used therapy proves ineffective or harmful.
The meniscus is a C-shaped cartilage pad that acts as a shock absorber in the knee. Tears can occur from sudden twists or gradually with age, and are often found incidentally on MRI scans in people without symptoms.
The trial involved 146 patients aged 35-65 from five Finnish hospitals. About a third had acute sports injuries, while two-thirds had gradual symptom onset. After 10 years, the surgery group had poorer knee function, greater osteoarthritis progression, and higher rates of subsequent knee surgery.
Consultant knee surgeon Mark Bowditch noted that best practice guidelines now recommend a six-month waiting period before considering surgery, as many symptoms resolve with physiotherapy. However, he said some patients with mechanical symptoms like catching may still benefit.
Prof Järvinen highlighted that while independent guidelines recommend discontinuing the procedure, organisations like the American Academy of Orthopaedic Surgeons and the British Association for Surgery of the Knee continue to endorse it, illustrating the difficulty of abandoning ineffective therapies.
