A long-term Finnish study has found that one of the world’s most common orthopedic surgeries may not help patients as once believed. According to the Finnish Degenerative Meniscal Lesion Study, a procedure called partial meniscectomy offered no long-term improvement in knee symptoms or function compared to a sham operation.

Researchers followed participants for 10 years and discovered that those who underwent the actual surgery often fared worse than those who did not. The findings indicated more persistent symptoms, reduced knee performance, and greater progression of osteoarthritis among surgical patients.

The study also found that people who received partial meniscectomy were more likely to need additional knee surgery over the next decade. This outcome challenges long-held assumptions about the benefits of trimming damaged meniscal tissue to relieve pain.

Led by Professor Teppo Järvinen at the University of Helsinki, the research team described these results as a potential example of “medical reversal,” where a widely used procedure is later shown to lack effectiveness. The study’s design included a sham surgery control group, allowing for a rare direct comparison between actual and placebo procedures.

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“The surgery is based on the assumption that pain in the inside of the knee is caused by a medial meniscus tear, which can be treated surgically,” said Raine Sihvonen, Specialist in Orthopaedics and Traumatology and one of the principal investigators. “Such reasoning, assumption based on biological credibility, is still very common in medicine but in this case, the assumption does not withstand critical examination.”

Sihvonen explained that pain is often linked to age-related joint degeneration rather than a specific tear. That insight, supported by the 10-year follow-up data, adds to growing evidence that surgical intervention may not always be the best course for degenerative knee conditions.

Earlier registry and observational studies had already signaled potential downsides. These included higher rates of subsequent joint replacement and increased post-surgical complications among patients who previously had partial meniscectomy.

Dr. Roope Kalske, a Doctoral Researcher and Specialist in Orthopaedics and Traumatology, noted that multiple randomized trials have found no improvement in symptoms or function after one, two, or even five years post-surgery. Despite this, he said, “the procedure has remained widely used in many countries.”

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The research underscores the challenge of changing medical practice even when data show limited benefit. Järvinen described this as a larger problem in healthcare, where established procedures can persist long after evidence questions their effectiveness.

“This effectively illustrates how difficult it is to give up inefficient therapies,” Järvinen said.

The study involved five hospitals across Finland, demonstrating both extensive collaboration and high patient engagement. More than 90 percent of the original 146 participants completed the decade-long follow-up.

“The study conducted in five hospitals is an example of smooth multicenter collaboration, as well as the commitment of research patients to an interesting project,” said research manager Pirjo Toivonen.

The project was carried out as part of the FICEBO research group’s continuing effort to assess surgical treatment outcomes. Institutions involved included the university hospitals of Helsinki, Kuopio, and Turku, Hatanpää Hospital in Tampere, Hospital Nova in Jyväskylä, and the Finnish Institute for Health and Welfare.

Results from this 10-year randomized study contribute significant evidence to the debate over partial meniscectomy.

By confirming that the surgery fails to outperform a placebo over a decade, the work could influence clinicians and policymakers reconsidering how degenerative meniscal tears are treated.

The study, published in the New England Journal of Medicine, reopens discussion about how surgical assumptions are tested and validated over time. It also spotlights the continuing need for rigorous, long-term follow-up in orthopedic research to ensure patient benefit is real, lasting, and supported by data.