Each year, 400,000 Americans who are middle-aged and older have meniscus surgery. Given that there is not a clear relationship between knee pain and meniscus tears, orthopedists have wondered if the operations even make sense.

The results of a clinical trial performed by Dr. Jeffrey Katz, a professor of medicine and orthopedic surgery at Harvard Medical School, concluded that meniscus surgery offered little to most who have it. Other studies have come to the same conclusion; then in July, yet another study was published in The British Medical Journal that showed the surgery offered no additional benefit.

An accompanying editorial added that the surgery is in fact “a highly questionable practice without supporting evidence of even moderate quality,” and that “Good evidence has been widely ignored.”

Patients should be told that physical therapy is a good first-line therapy for pain relief and whether the surgery should be mentioned at all is up for debate among doctors. Ultimately, it is up to the patient to decide, but patients need all the information in order to make an informed decision about what is best for them. This New York Times article discusses this surgery among other potentially “useless” surgeries. Unlike drugs, which go through rigorous testing under the watchful eye of the Food and Drug Administration, surgeries do not undergo clinical trials and are not regulated by the FDA.