Many Adults Still Undergo Unnecessary Knee Surgery

• Despite years of compelling evidence, unnecessary meniscus surgery remains common — and geography plays a major role.
• New analysis from Motive Medical Intelligence of more than 100 million U.S. insurance claims finds wide state-by-state variation in low-value meniscus surgery.
• More than 500,000 arthroscopic meniscectomies are still performed in the U.S. each year, at a cost of roughly $4 billion.

SAN FRANCISCO, July 22, 2026 /PRNewswire/ -- Hundreds of thousands of adults undergo knee surgery each year for age-related meniscus tears, despite years of compelling clinical evidence showing that many patients receive little or no benefit when compared with physical therapy or even when compared with sham (placebo) surgery.

A new analysis of more than 100 million U.S. insurance claims by Motive Medical Intelligence (Motive) found that unnecessary meniscectomy remains common across the country, and that a patient's likelihood of undergoing the procedure varies substantially depending on where they live.

For decades, meniscectomy — the surgical removal of damaged tissue from the knee's meniscus, a crescent-shaped cartilage that cushions and stabilizes the joint — has been one of the most commonly performed surgeries in the U.S. But most middle-aged adults whose meniscus tears result from aging and degeneration rather than trauma may not need surgery. For these patients, randomized clinical trials have shown that meniscectomy provides little or no additional benefit compared with physical therapy and, in one landmark study, no benefit compared with sham, or placebo, surgery.

Nevertheless, more than 500,000 arthroscopic meniscectomies are still performed in the U.S. each year, at a cost of approximately $4 billion. Because many of these procedures are unlikely to improve patient outcomes, reducing unnecessary meniscectomies represents a significant opportunity to protect patients from avoidable surgery while lowering healthcare costs.

Motive's analysis reveals substantial geographic variation in the use of low-value meniscus surgery. The states with the poorest performance, those with the highest percentage of unnecessary surgeries, include:

• South Dakota: 46%
• Iowa: 42%
• Wisconsin: 42%
• Arkansas: 40%
• Utah: 40%

The states with the best performance include:

• New Jersey: 19%
• California: 20%
• Florida: 22%
• Maryland: 22%
• New York: 22%

Even in the best-performing states, roughly one in five eligible patients underwent meniscus surgery that evidence suggests was unlikely to provide meaningful benefit.

"One of the striking findings in these data is the enormous variation across states," said Julie Scherer, PhD, Motive's Chief Data Scientist. "Some states have reduced unnecessary meniscus surgery to fewer than one in five eligible patients, while others continue to perform these low-value procedures in nearly half of eligible patients. Variation of this magnitude tells us that improvement is possible."

Professional medical societies have sought to address the persistent use of low-value meniscectomy. The American Academy of Orthopaedic Surgeons (AAOS) recommends reserving the procedure for patients who have failed conservative treatment and who have specific symptoms that may justify surgery, rather than relying on MRI abnormalities alone.

The AAOS recommendation is supported by major randomized clinical trials, including the METEOR trial and the FIDELITY trial. The METEOR trial compared arthroscopic partial meniscectomy with a standardized physical therapy regimen in patients ages 45 and older who had a meniscal tear and mild-to-moderate knee osteoarthritis. The study found no significant difference in functional improvement between patients assigned to surgery and those assigned to physical therapy. The landmark FIDELITY trial subjected arthroscopic partial meniscectomy to an especially rigorous test by comparing it with sham, or placebo, surgery. In that study, patients with degenerative meniscus tears who underwent actual meniscectomy did no better than patients who underwent a simulated surgical procedure.

"It is rare for a surgical procedure to be subjected to the ultimate rigor of a sham-controlled randomized trial," said Rich Klasco, MD, Motive's Chief Medical Officer. "Doctors have a duty to incorporate such convincing evidence into their practice."

The findings underscore a broader challenge in U.S. healthcare: Strong clinical evidence does not always translate quickly or consistently into changes in medical practice. When evidence-based recommendations are applied unevenly, patients may receive very different care depending on their physician, health system, or geographic location. Reducing unnecessary meniscus surgery could help patients avoid the risks, recovery time, inconvenience, and expense associated with a procedure that may not improve their pain or function.

Study Methodology
The study was conducted using Motive's Practicing Wisely data analytics system, which measures individual clinician performance across appropriateness of care, quality, and waste. By mapping closed-claims data to evidence-based standards of care, Motive's expert team can measure individual clinician decisions at the point of care, share actionable insights back to the clinician, and help improve clinical performance to drive positive change across the U.S. health system. Practicing Wisely delivers unique insights into how individual clinicians perform against evidence-based standards, benchmarked against their peers, enabling health plans and systems to more accurately assess risk, reduce waste, move toward quality care, and drive high-value outcomes at scale.

About Motive Medical Intelligence
Motive Medical Intelligence is redefining healthcare performance analytics with an emphasis on transparency, physician trust, and real-world actionability. Motive is the partner of choice for organizations committed to eliminating low-value care and thriving in value-based care models.

Through its proprietary Practicing Wisely solution, Motive is helping the industry eliminate the $400 billion in annual waste in the U.S. health system, advance the transition to high-value, patient-centered care, and achieve the quadruple aim. Learn more here.

Media: Supreme Communications for Motive Medical Intelligence: [email protected]

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SOURCE Motive Medical Intelligence