Key Findings

A 10-year follow-up of the Finnish Degenerative Meniscal Lesion Study (FIDELITY) found that partial meniscectomy, a common knee surgery, did not improve symptoms or function compared to a sham procedure.

Patients who received the actual surgery reported worse knee symptoms and function, showed greater osteoarthritis progression, and were more likely to need additional knee surgery.

Study Design

The FIDELITY trial randomly assigned participants with degenerative meniscal tears to either partial meniscectomy or sham surgery and tracked outcomes for 10 years. Over 90% of the original 146 participants completed follow-up. The study involved five hospitals in Finland.

Statements from Researchers

Teppo Järvinen, Professor at the University of Helsinki and principal investigator:

“The results suggest a possible medical reversal, where a widely used therapy proves ineffective or harmful.”

Raine Sihvonen, Specialist in Orthopaedics and Traumatology:

“The surgery assumes pain is caused by a meniscus tear, but the assumption does not withstand critical examination. Pain is related to joint degeneration from aging.”

Roope Kalske, Doctoral Researcher:

Previous randomized studies showed no benefit at 1-2 or 5 years, yet the procedure remains common.

Background

Partial meniscectomy is one of the most common orthopedic surgeries globally. Its use in Finland has declined, but it remains routine in many countries.

Several clinical guidelines have recommended discontinuing the procedure, though organizations like the American Academy of Orthopedic Surgeons and the British Association for Surgery of the Knee still endorse it.