FIDELITY study finds arthroscopic partial meniscectomy offers no benefit at 10 years
Updated
Updated · Medscape · Apr 30
FIDELITY study finds arthroscopic partial meniscectomy offers no benefit at 10 years
9 articles · Updated · Medscape · Apr 30
Among 133 patients assessed, clinical knee osteoarthritis developed in 22% of the surgery group versus 19% after sham surgery, with later major knee operations in 12% versus 4%.
The trial originally randomised 146 adults aged 35 to 65 with degenerative meniscal tear symptoms, and found no significant differences in function, quality of life or exercise-related knee pain.
Researchers and outside experts said the placebo-controlled findings reinforce earlier one- and five-year results and suggest the procedure may accelerate joint degeneration, though not for acute tears or locked knees.
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10-Year FIDELITY Trial Reveals Meniscectomy’s Lack of Benefit and Long-Term Harm in Degenerative Knee Tears
Overview
A landmark 10-year trial revealed that arthroscopic partial meniscectomy (APM) for degenerative knee tears offers no real improvement in pain or function compared to sham surgery, while causing accelerated osteoarthritis, worse knee function, and more surgeries over time. This harm is linked to meniscectomy reducing the knee's contact area, which increases pressure on cartilage and speeds joint degeneration. In contrast, meniscal repair preserves joint mechanics and proprioception, lowering arthritis risk and future knee replacements, though it carries a higher early re-operation rate. Current guidelines emphasize physical therapy first, but surgical traditions and incentives slow adoption of these evidence-based practices.