When I was in my 20s, I injured my knee playing football. At that time, I was told I needed surgery. Surgery to repair the torn ligament and meniscus was supposed to prevent arthritis later. Now I’m in my early 40s and guess what? I have all the signs that arthritis is developing in that knee anyway. How come?

For many years, studies reported that surgery to repair or reconstruct the damaged structures of the knee could protect the joint. The positive role of surgery for anterior cruciate ligament (ACL) repair and meniscus tears was strongly suggested.

Taking a closer look now shows a lack of evidence that surgery has a protective role in these patients. When researchers tried to pool or combine the data from many studies on the topic, they found poor reporting of important variables. Without quality research and reporting, the data can’t be compared from one study to another.

Even with improved surgical methods, outcomes in more recent patient reports don’t appear to be any better. If anything, improved technology has made it possible to show arthritic changes as they develop earlier in the process than ever before.

Surgical treatment may benefit some patients. But for now, there is a lack of convincing evidence to support our previous belief that surgery is needed to avoid the later development of osteoarthritis.

It’s possible there are other risk factors and events that affect the outcome more than surgery. Finding out what these are is the focus of current research.