Is knee surgery for a torn meniscus necessary and curative? A New England Journal of Medicine study raises some doubts.

We all know someone who developed knee pain and then had meniscus surgery to remove the torn part of the cartilage. The question is; does this solve the problem and result in a cure? A New England Journal of Medicine study raises some doubts and offers some insight as to why non-surgical options can work better or just as well as surgery.

In our office, we help many people with knee problems by solving the mechanisms behind knee pain. Since the meniscus tear is often a symptom, rather than the problem, looking at the foot, ankle, and hip, as well as the lower back region, resolves most knee pain even when a meniscus tear is present. If this works that well, why do we need surgery, even if a tear is present? This study indicates that meniscus surgery may not be any more effective than a sham surgery procedure.

Non-surgical interventions are often better and definitely less risky and inconvenient than going under the knife. Now, the New England Journal of Medicine has evidence that this approach is effective or more effective than surgery in many cases.

Common Knee Surgery Does Very Little for Some, Study Suggests

By PAM BELLUCK

A popular surgical procedure worked no better than fake operations in helping people with one type of common knee problem, suggesting that thousands of people may be undergoing unnecessary surgery, a new study in The New England Journal of Medicine reports.

The unusual study involved people with a torn meniscus, crescent-shaped cartilage that helps cushion and stabilizes knees. Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion.

The study, conducted in Finland, involved a small subset of meniscal tears. But experts, including some orthopedic surgeons, said the study added to other recent research suggesting that meniscal surgery should be aimed at a narrower group of patients; that for many, options like physical therapy may be as good.

The surgery, arthroscopic partial meniscectomy, involves small incisions. They are to accommodate the arthroscope, which allows doctors to see inside, and for tools to trim torn meniscus and to smooth ragged edges of what remains.

The Finnish study does not indicate that surgery never helps; there is a consensus that it should be performed in some circumstances, especially for younger patients and for tears from acute sports injuries. But about 80 percent of tears develop from wear and aging, and some researchers believe surgery in those cases should be significantly limited.

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