Is Meniscus Surgery a Sham?

Adults with severe knee pain are often told they have a meniscus tear and surgery is needed. In fact, with approximately 700,000 procedures per year, arthroscopic surgery to shave off worn or torn pieces of the meniscus is the most common orthopedic procedure performed in the United States. But a new study suggests many meniscus surgeries are unnecessary. 

The meniscus is a piece of cartilage that buffers the knee joint and allows extension and movement of the knee. Symptoms of a problem meniscus include: 

• A popping sound at the joint at the time of the injury or afterward
• Locking of the joint and resulting inability to flex the joint
• Pain and swelling of the knee
• Limited range of movement of the knee 

A recent Finnish study published in the New England Journal of Medicine evaluated 146 patients diagnosed with meniscus tears. Half of the patients received meniscus surgery and the other half underwent a fake, noninvasive procedure. The results include: 

• One year later, there was no difference in symptoms between those who received actual surgery and those who did not.
• No difference in symptoms or need for additional surgery was noted between the groups. 

The study does not discredit meniscus surgery but raises questions about doctors’ eagerness to recommend it. Patients with sports injuries or sudden injuries appear to receive more benefit from the surgery than older patients with “wear and tear” injuries. 

Meniscus surgery is big business, costing about $4 billion each year in the United States. Every surgery is an opportunity for a medical mistake or unexpected complication. If your surgeon recommends meniscus surgery, consider seeking a second opinion.