Is This Common Knee Surgery Effective?

Is This Common Knee Surgery Effective?

For people with knee pain, going under the knife is an all-too-common occurrence. More than 700,000 Americans have arthroscopic surgery each year to treat osteoarthritis or repair a torn meniscus, the cartilage cushion inside the knee. About 90% of people who tear a meniscus have osteoarthritis. In the procedure, a surgeon inserts instruments into the knee through small incisions to to clear debris out of the joint and relieve pain.

But research shows that for many, maybe most, of those people, the surgery doesn’t do much good.

Real surgery no better than “fake”
In a study published in the New England Journal of Medicine, doctors performed an experiment on patients age 35 through 65 who were suffering from knee pain and had a torn meniscus, but who didn’t have arthritis. Half of the patients had their menisci repaired, but the rest received a sham surgery instead. In the operating room, surgeons did everything they could to make the sham surgery seem real, including using instruments with the blades removed and moving the knee as they would during the operation.

The result: Most patients in both groups were happy with how the procedure (or “procedure”) went. The study revealed that 89 percent of people who had surgery and 80 percent who didn’t reported that their knee pain improved. In short, the surgery appeared to do nothing more than make people think they felt better — basically a placebo effect.

And this isn’t the first study to question the value of arthroscopic surgery. A previous trial found that, among people with osteoarthritis, the procedure was no better than physical therapy at relieving pain. And before that, another study showed that sham surgery was just as good as the real thing for treating osteoarthritis.

So what does this mean for you?
The growing consensus is that surgery is rarely the right treatment for OA, and that physical therapy and pain medication are usually better choices for meniscus tears. That’s not to say the surgery isn’t appropriate for anyone, though. Experts say it could help people who tear a meniscus suddenly, such as while playing sports, people who have clicking or “catching” when they move their knee and those who don’t get relief from physical therapy. If you have knee pain, talk to your doctor to find the remedy that’s right for you, whether it’s surgery, therapy or even holistic therapies or easy exercises.

Medically reviewed in January 2020.

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