Meniscus surgery is one of the most commonly performed orthopedic procedures, with over a million cases reported annually in the US alone.

The meniscus is a crescent-shaped cartilage that acts as a cushion between the femur and the tibia, helping stabilize the knee joint. Damage to the meniscus can occur due to a sudden twist or a gradual degeneration over time. For many years, meniscus surgery was considered the gold standard for treating meniscal tears.

However, recent studies have suggested that the procedure may be unnecessary in many cases.

The Controversy Surrounding Meniscus Surgery

In 2013, researchers from Finland conducted a study to determine the effectiveness of meniscus surgery.

The study involved a group of patients with knee pain caused by a meniscal tear, who were randomly assigned to undergo either arthroscopic surgery or a sham surgery (where a small incision was made in the knee but no actual surgery was performed). The results showed that both groups of patients experienced similar levels of pain relief and functional improvement, indicating that meniscus surgery may be a pointless procedure for many patients.

Since then, several other studies have produced similar results. In 2016, a study published in the British Medical Journal analyzed data from 10 randomized controlled trials involving over 1200 patients with meniscal tears.

The researchers found that there was no significant difference in pain relief or functional improvement between patients who underwent meniscus surgery and those who received non-surgical treatments such as physical therapy or exercise therapy.

Why Meniscus Surgery May Be Pointless

Meniscus surgery is still widely performed because doctors believe that it can prevent further damage to the knee joint and delay the need for knee replacement surgery. However, the research suggests that this may not be the case.

In fact, meniscus surgery may actually increase the risk of knee osteoarthritis (OA) in some patients.

Osteoarthritis is a degenerative joint disease that causes pain and stiffness in the joints. It is a common complication of meniscal tears and is one of the main reasons why doctors recommend meniscus surgery.

However, several studies have found that meniscus surgery does not reduce the risk of OA and may even increase it in some cases.

One reason why meniscus surgery may be pointless is that not all meniscal tears are symptomatic. Many people have meniscal tears that do not cause any pain or functional impairment, and these tears may be falsely diagnosed as the cause of knee pain.

According to a study published in the Journal of Bone and Joint Surgery, up to 60% of people over the age of 60 have meniscal tears, but only a small percentage of them experience symptoms.

When Meniscus Surgery May Be Necessary

Despite the controversy surrounding meniscus surgery, there are still some cases where the procedure may be necessary.

Meniscal tears that cause severe pain, locking or catching of the knee, and significant functional impairment may require surgical intervention. In addition, surgery may be recommended for younger patients with traumatic meniscal tears or those with a higher risk of knee OA.

However, even in these cases, non-surgical treatments should be considered first. Physical therapy, exercise therapy, and weight management can all help reduce knee pain and improve function without the risks associated with surgery.

In addition, some patients may benefit from a conservative approach of watchful waiting, where they are monitored over time to see if their symptoms improve on their own.

The Risks and Costs of Meniscus Surgery

Meniscus surgery is a relatively safe procedure, with a low risk of serious complications such as infection or blood clots. However, like all surgeries, it is not without risks.

Potential complications of meniscus surgery include nerve damage, blood vessel injury, and further damage to the knee joint.

In addition, meniscus surgery can be expensive, with costs ranging from $5,000 to $15,000 or more. This can be a financial burden for many patients, especially those without insurance coverage.

Conclusion

Meniscus surgery is a controversial procedure, and recent research suggests that it may be unnecessary for many patients with meniscal tears. While the procedure may be necessary in some cases, non-surgical treatments should be considered first.

Patients should be aware of the risks and costs associated with meniscus surgery and should carefully weigh the benefits against the potential harms before deciding to undergo the procedure.