Finnish Study Finds Knee Surgery Offers Little Benefit for Degenerative Tears

A Finnish study that tracked patients for 10 years after arthroscopic knee surgery to trim degenerative cartilage tears or a sham skin incision found the procedure delivered little or no benefit and was associated with accelerated osteoarthritis and higher rates of reoperation, typically total knee replacement, @CBSNews reported.

Teppo Järvinen, an orthopedist and head of the Finnish Centre for Evidence-Based Orthopaedics, said the results showed patients who underwent the surgery experienced more pain and worse outcomes across all measured scores. "I don't know how I would defend this procedure at all," Järvinen stated.

"What has been shown dramatically is that patients who have this procedure have more pain — they do worse. " The study, published in April in the New England Journal of Medicine, focused on middle-aged or older subjects with knee pain whose MRIs showed cartilage tears, the group considered most likely to benefit. It does not apply to tears from acute injuries.

Arthroscopic rates in Finland have fallen 90 percent since evidence accumulated against the procedure. In the United States the decline has been slower. Commercial claims data counted more than 2 million meniscus surgeries from 2010 to 2020, with volumes dropping about 4 percent annually.

In traditional Medicare, procedures declined from roughly 169,000 in 2014 to 91,000 in 2024. Medicare pays between $2,159 and $3,875 on average for the 30-to-60-minute operation, with patients responsible for 20 percent coinsurance. Commercial insurers reimburse more than twice that amount on average.

Last summer a consensus statement from orthopedic societies in Europe and the United States concluded that degenerative meniscus lesions can be treated with comparable results through non-operative care, including physical therapy, or surgery. The statement recommended trying physical therapy first but still endorsed the operation.