Meniscus surgery is the most commonly performed surgical procedure in orthopaedics. Almost two-thirds of the patients are over 45 years old. It is not known, however, whether a torn meniscus in older patients is the primary cause of knee pain, or whether the pain is caused by an ongoing degenerative process. Until 2013, there were hardly any studies comparing the efficacy of meniscus surgery with ... [Show full abstract] that of a non-surgical approach in this group of patients. This has recently changed with the publication of two randomized controlled studies comparing arthroscopic meniscectomy with conservative therapy. The studies showed that meniscectomy had no added value to physical therapy. This commentary briefly discusses these studies and discloses the lack of current knowledge on the aspect of cost-effectiveness of these treatments.