For decades, a common surgery has been used to treat knee pain caused by wear and tear. This operation, called partial meniscectomy, involves trimming damaged cartilage inside the knee.
It has been performed millions of times around the world and is often seen as a routine solution for ongoing knee discomfort.
But a new long-term study is raising serious doubts about whether this surgery actually helps patients. The research, published in the New England Journal of Medicine, followed patients for 10 years and found that the surgery did not improve symptoms or function compared to a placebo procedure.
The study is part of the Finnish Degenerative Meniscal Lesion Study, also known as FIDELITY. It stands out because of its strong design and long follow-up period.
In the study, patients were randomly assigned to receive either real surgery or a sham surgery, where no actual treatment was performed. This method allows researchers to separate the true effect of the surgery from the patient’s expectations.
Participants in the study had meniscal tears caused by degeneration rather than injury. This type of damage is common in older adults and is often linked to the natural aging process. The patients were tracked over time to see how their symptoms and knee function changed.
After a decade, the results showed no benefit from the surgery. Patients who underwent partial meniscectomy did not have better pain relief or improved mobility compared to those who had the sham procedure. In fact, the surgical group showed worse outcomes in several areas.
They reported more symptoms, had poorer knee function, and showed greater progression of osteoarthritis. Osteoarthritis is a condition where the joint becomes damaged over time, leading to pain and stiffness. The study also found that patients who had the surgery were more likely to need additional knee operations later on.
These findings suggest that the surgery may not address the real cause of the problem. Instead of being caused by a specific tear, knee pain in these cases may be linked to broader joint degeneration. Removing part of the meniscus may not fix this issue and could even make it worse.
Experts describe this situation as a medical reversal. This happens when a treatment that was once widely accepted is later shown to be ineffective or harmful. It highlights the importance of testing medical treatments carefully before continuing their widespread use.
Although earlier studies had already questioned the value of this surgery, it remains common in many countries. Some medical organizations have recommended reducing its use, but others continue to support it. This shows how challenging it can be to change established medical practices.
The study also builds on concerns from previous research. Observational studies had suggested that the surgery might increase the risk of joint replacement in the future. While those studies could not prove a direct cause, the new randomized trial provides stronger evidence.
One strength of the research is its high participation rate. More than 90 percent of the original patients completed the 10-year follow-up, which adds credibility to the findings.
In summary, this study provides strong evidence that partial meniscectomy does not improve outcomes for patients with degenerative meniscal tears and may even lead to worse long-term results. It suggests that doctors should reconsider the use of this surgery and focus more on alternative treatments such as physical therapy and lifestyle changes.
The findings also serve as a reminder that medical practices must evolve based on evidence. Even widely accepted treatments should be re-examined as new data becomes available.
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Source: University of Helsinki.
