Common knee surgery may worsen pain and accelerate arthritis, 10-year study finds

Thousands of Americans undergoing a common knee surgery to trim degenerative cartilage tears may be worsening their condition, a decade-long study suggests. The research, published in the New England Journal of Medicine, followed patients who received either the actual surgery or a sham procedure involving only a skin incision. The findings indicate that the surgery provided minimal to no benefit and was linked to accelerated osteoarthritis and increased rates of reoperation, often necessitating a total knee replacement.

Teppo Järvinen, an orthopedist and lead author of the study, expressed strong reservations about the procedure's value. "I don't know how I would defend this procedure at all," he stated, noting that patients who underwent the surgery reported more pain and poorer outcomes across all measured scores. Järvinen highlighted that the study specifically selected patients most likely to benefit, making the negative results even more compelling. This research, however, does not apply to cartilage tears resulting from acute injuries.

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I don't know how I would defend this procedure at all. What has been shown dramatically is that patients who have this procedure have more pain, they do worse. All the scores pointed in the same direction.

Evidence questioning the efficacy of arthroscopic knee surgery for degenerative cartilage has been mounting for over a decade, with some countries seeing significant drops in the procedure's rates. While Finland's rates have plummeted by 90%, the U.S. has seen a slower decline. Despite these findings, some experts acknowledge that a portion of patients do benefit, though current practices vary widely among physicians. The study underscores a growing debate about the necessity and effectiveness of this common surgical intervention for knee pain.

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Nothing supports the idea that a patient's pain comes from the meniscus.