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Executive Summary: Surgery’s Surprising BackfireA 10‑year Finnish trial involving 146 patients aged 35‑65 reveals that partial meniscectomy for meniscus tears provides no functional benefit and leads to poorer knee health compared with sham surgery.Trial Design and Sham‑Control MethodologyResearchers from five Finnish hospitals randomly assigned participants to either traditional partial meniscectomy—trimming frayed cartilage—or a sham procedure where incisions were made but no tissue was removed. This rigorous design isolates the surgical effect from placebo influences.Key Outcomes and Quantitative FindingsPatients undergoing surgery reported lower knee‑function scores after 10 years.Higher progression of osteoarthritis was observed in the surgical group.Increased likelihood of needing additional knee surgery compared with the sham group.Overall, the surgical cohort fared worse across pain, stiffness, and functional metrics.Implications for Orthopedic Practice and Guideline ShiftsLead author Prof Teppo Järvinen describes the results as a classic “medical reversal,” challenging decades of routine meniscectomy. The study supports recent guideline updates that extend the recommended observation period from three to six months before considering surgery. Nonetheless, some clinicians, such as Mark Bowditch, note that a subset of patients with mechanical catching may still benefit.Future Outlook: Toward Conservative ManagementWith major bodies like the American Academy of Orthopaedic Surgeons and the British Association for Surgery of the Knee facing mounting evidence, the field is likely to see a continued decline in elective meniscus surgeries. Expect greater emphasis on physiotherapy, patient education, and stricter criteria for operative intervention, while ongoing research monitors long‑term outcomes of non‑surgical pathways.