Study Questions Value of Common Knee Surgery

Procedure to repair a torn meniscus worked no better than a fake one to ease lingering pain

HealthDay—December 26, 2013

Improvements in knee pain following a common orthopedic procedure appear to be largely due to the placebo effect, a new Finnish study suggests.

The research, which was published Dec. 26 in the New England Journal of Medicine, has weighty implications for the 700,000 patients who have arthroscopic surgery each year in the United States to repair a torn meniscus. A meniscus is a C-shaped pad of cartilage that cushions the knee joint.

For a meniscal repair, orthopedic surgeons use a camera and tiny instruments inserted through small incisions around the knee to shave damaged tissue away. The idea is that clearing sharp and unstable debris out of the joint should relieve pain. But mounting evidence suggests that, for many patients, the procedure just doesn't work as intended.

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Despite the latest round of discouraging results, several experts said it was important not to overgeneralize the latest findings.

"I think we should be careful making the blanket conclusion that there's no role for meniscus surgery," said Dr. Scott Rodeo, an attending orthopedic surgeon at Hospital for Special Surgery in New York City. Rodeo said he thought meniscal repair could still be helpful for patients who experience mechanical symptoms like clicking and catching when they move their knee.

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