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Recently, the New York Times asked why ‘useless’ surgery is still popular.1 In this editorial we outline three factors that likely promote continuing use of arthroscopic partial meniscectomy, for more than 350 000 middle-aged and older Americans (>35 years) annually. These operations occur despite there being no scientific evidence for a benefit over placebo and despite clinical guidelines increasingly recommending against arthroscopic partial meniscectomy. We close with a call to action recommending patients, clinicians, researchers and funders to act and stop supporting ‘useless’ medical treatments.
It sounds plausible! But so does ‘removing tonsils’…
A medical procedure is often accepted as effective if a logical story describes how symptoms arise and how the treatment provides a cure. The dogma that removing or trimming torn meniscal tissue is necessary to improve knee symptoms is outdated. Nine randomised studies provide strong evidence that knee arthroscopy provides no greater pain relief or other improvements when compared to placebo or added to exercise.2 Our recent randomised study compared exercise therapy of sufficient quality and …
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.