Study Questions Benefits of Common Knee Surgery for Degenerative Cartilage Tears

A long-term study suggests that arthroscopic knee surgery to remove damaged cartilage may offer little benefit for patients with age-related meniscus tears and could even accelerate joint deterioration.

Researchers followed patients for 10 years after they underwent either arthroscopic surgery or a placebo procedure involving only a skin incision. According to the findings, published in the New England Journal of Medicine, patients who received the surgery experienced no meaningful improvement in pain or function compared with those who underwent sham surgery. They were also more likely to develop faster-progressing osteoarthritis and require additional surgery, including total knee replacement.

The study focused on middle-aged and older adults with knee pain caused by degenerative cartilage tears detected on MRI. It did not include patients with acute traumatic knee injuries.

Evidence accumulated over the past decade has increasingly suggested that arthroscopic surgery is no more effective than physical therapy for treating degenerative meniscus tears. As a result, the use of the procedure has declined substantially in several countries, although it remains relatively common in the United States.

Experts note that degenerative meniscus tears are frequently found in people over the age of 50 and are often part of the normal aging process rather than the direct cause of knee pain.

Many orthopedic specialists now recommend conservative treatment as the first option, including physical therapy, exercise and weight management when appropriate. Surgery may still be considered in selected cases, but its routine use for degenerative meniscus tears is being increasingly questioned.

Alternative treatments, such as steroid injections, may provide temporary symptom relief, while therapies involving platelet-rich plasma or stem cells remain under investigation because current evidence for their effectiveness is inconclusive.

When conservative measures fail and severe osteoarthritis develops, total knee replacement remains the standard surgical treatment.

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