Every year, millions of people go under the knife, and a growing pile of research says many of these are unnecessary surgeries that work no better than a fake procedure. Doctors literally pretended to operate on patients, and those patients got better at the same rate. Surgery saves lives. Nobody’s arguing that. But the science is getting harder to ignore.
Estimates suggest that up to 30% of certain common procedures may be unwarranted. The financial cost? Billions. These are bread-and-butter operations happening in hospitals right now, all over the world. So grab your coffee and sit down for this one. Here are 10 Unnecessary Surgeries the Evidence No Longer Supports
10. Routine Episiotomy
For decades, doctors cut the tissue between the vagina and anus during childbirth as standard practice. The logic seemed simple enough: a clean surgical cut heals better than a natural tear. Turns out, that logic was flat-out wrong.
The World Health Organization now recommends against routine episiotomy, and the American College of Obstetricians and Gynecologists followed suit in 2006. A Cochrane review found that women who had selective episiotomies (only when truly needed) experienced less trauma, needed fewer stitches, and had fewer healing complications. In some countries, rates used to sit above 50%. In the U.S., the rate dropped from 67% in 2012 to about 4.6% by 2022. But in many developing countries, the approach persists. The WHO’s position is clear: there is no evidence supporting routine episiotomy, and it can actually increase the risk of severe tears and long-term pain. (10) Harvard T.H. Chan School of Public Health
9. Prophylactic Wisdom Teeth Removal
If you grew up in the U.S. or Australia, there’s a good chance a dentist told you those wisdom teeth had to come out. Didn’t matter if they were causing problems. The thinking was: get them out now before they cause trouble later.
The trouble is, for a lot of people, that trouble never actually comes. A 1988 study found that only 12% of people who kept their impacted wisdom teeth experienced any complication. A 2011 Greek study of over 6,000 extractions found only 2.8% had a cyst or tumor. The Cochrane Review concluded there isn’t enough evidence to support pulling healthy, symptom-free wisdom teeth. The UK stopped recommending routine removal in 1998 after a University of York study found no scientific justification. A 2007 paper in the American Journal of Public Health estimated that half of upper wisdom teeth classified as impacted were developing normally. About 10 million wisdom teeth get pulled in the U.S. every year. How many actually needed to go? (9) Science Alert: Evidence Is Mounting That Routine Wisdom Teeth Removal Is a Waste of Time
8. Hysterectomy for Benign Conditions
The hysterectomy is one of the most common surgeries performed on women and one of the most frequently cited unnecessary surgeries in medical literature. In the U.S., about 600,000 happen every year. And a shocking number may not be needed. Studies found that hysterectomies were improperly recommended in up to 70% of cases where non-surgical alternatives existed.
We’re talking about conditions like fibroids, heavy bleeding, and endometriosis. Real, painful problems. But less drastic options like medication, hormonal IUDs, and uterine artery embolization can manage symptoms for many patients. A hysterectomy is permanent. You lose the uterus. You can face early menopause, bladder issues, bowel complications, and changes in sexual function. The decision to remove an organ should come after exhausting alternatives, not as a first option. Yet for many women, it’s presented as the default. This is slowly changing, but the gap between what evidence says and what happens in practice remains wide. (8)
7. Cesarean Section (Overuse)
C-sections save lives when they’re needed. Full stop. But the WHO says that C-section rates above about 10-15% at the population level don’t lead to further reductions in maternal or newborn deaths. In the U.S., the rate sits around 32%. In Brazil, it’s hit 56% in private hospitals.
A systematic review covering over 9.1 million procedures across 63 countries found that unnecessary cesarean delivery topped the list of unnecessary surgeries worldwide, with estimated rates ranging from 12% to 81%. One study found that the physical layout of a hospital predicted C-section rates: the further apart the delivery rooms, the higher the rate. The architecture of a building was influencing surgical decisions about women’s bodies. C-sections carry real risks: infection, hemorrhage, blood clots, breathing problems for the baby, and complications in future pregnancies. When it’s necessary, it’s a lifesaver. When it’s not, it’s a major abdominal surgery performed without good reason. (7)
6. Vertebroplasty for Spinal Compression Fractures
Vertebroplasty sounds reasonable. An elderly person fractures a bone in their spine from osteoporosis, and a doctor injects medical-grade cement into the cracked bone to stabilize it. Early studies reported pain relief rates of 75-90%.
Then in 2009, the New England Journal of Medicine published a randomized trial comparing vertebroplasty to a sham procedure. In the sham group, patients went through the whole experience: the operating room, the local anesthetic, even pressure on their back to simulate the injection. But no cement was injected. Both groups improved at the same rate. No difference in pain relief at one week, one month, three months, or six months. A second sham-controlled trial called VERTOS IV confirmed these findings. The improvements people felt after “real” vertebroplasty appear to come from the placebo effect, not the cement itself. Insurance companies have since become less willing to cover it. (6)
5. Shoulder Decompression Surgery (Subacromial Decompression)
Got persistent shoulder pain? An orthopedic surgeon might suggest shaving down a bone spur through a procedure called subacromial decompression. It’s one of the most common shoulder operations worldwide. The theory: removing the spur gives tendons more room, which reduces pain.
The 2018 CSAW trial tested this at 32 UK hospitals. They split patients into three groups: real decompression surgery, a placebo surgery where the scope went in but nothing was removed, and no surgery at all. After six months, real surgery showed no meaningful benefit over fake surgery. Both surgery groups did slightly better than no treatment, but the gap between real and placebo was basically zero. A Finnish trial called FIMPACT found the same thing. The benefit people reported came from the act of having surgery, not from the bone spur removal. (5)
4. Arthroscopic Partial Meniscectomy (Meniscus Tear Surgery)
You tore your meniscus. The little C-shaped cartilage in your knee that acts as a shock absorber. The surgeon says the torn bit needs to go. Sounds logical. But for the millions of middle-aged and older people with degenerative meniscus tears (the kind that come from wear and age, not a sports injury), the surgery doesn’t actually help.
The Finnish FIDELITY trial randomized 146 patients to either real meniscus surgery or a placebo procedure. At two years, and again at five years, there was no difference in pain, function, or knee osteoarthritis progression between the two groups. Multiple meta-analyses have confirmed: arthroscopic partial meniscectomy offers no benefit over non-surgical care or placebo surgery for degenerative tears. And it’s not cost-effective compared to the sham procedure. Despite this, millions of these operations still happen annually. The surgery works well for traumatic tears in younger patients, which makes doctors assume it works for everyone. It doesn’t. (4)
3. Spinal Fusion for Lower Back Pain
About a million spinal fusion surgeries happen globally every year. The procedure permanently bolts two or more vertebrae together and can cost anywhere from $50,000 to over $150,000. For many patients with common lower back pain, it works no better than physical therapy.
A Forbes report found that 50% of lumbar spine surgeries may be unnecessary. The Lown Institute reported over 30,000 unnecessary surgeries on the spine in just the first year of the pandemic, with 13,541 being fusions. European studies show that patients with worn-out discs often see no more benefit from fusion than from non-surgical treatment. The U.S. performs five times more spine surgery than the UK with no evidence of better outcomes. The financial incentive is enormous: a surgeon’s pay for a complex fusion can be 20 times higher than for simpler procedures. The North American Spine Society joined the Choosing Wisely campaign but couldn’t make clear recommendations for common spinal procedures due to insufficient evidence. (3) Becker’s Spine Review)
2. Knee Arthroscopy for Osteoarthritis
This is the one that really shook things up. In 2002, the New England Journal of Medicine published a landmark trial by Dr. Bruce Moseley. He took 180 patients with knee osteoarthritis and split them into three groups: one got arthroscopic debridement (cleaning out the joint), one got arthroscopic lavage (washing out the joint), and one got fake surgery. The fake surgery group received skin incisions and the sounds of a real operation, but nothing was actually done inside the knee.
Over two years, the placebo group did just as well as both surgical groups. At some points, the placebo patients actually reported better outcomes. A later Canadian trial confirmed the findings: arthroscopy for knee osteoarthritis, on top of physical therapy and medication, added no benefit. Over 650,000 of these procedures were performed annually in the U.S. at roughly $5,000 each. That’s over $3 billion a year on a surgery that a placebo matched. And it took years for practice to catch up. (2) The New England Journal of Medicine
1. Cardiac Stenting for Stable Angina
Here’s the big one. If you have stable chest pain from a narrowed artery (not a heart attack, just ongoing discomfort), your cardiologist might recommend a stent: a tiny metal tube propped inside the artery to hold it open. More blood flow equals less pain. It sounds like it should obviously work.
The 2007 COURAGE trial enrolled over 2,000 patients and found that stenting plus medication didn’t reduce the risk of death or heart attack compared to medication alone. Cardiologists pushed back, arguing stents still helped with symptoms. So in 2017, the ORBITA trial ran a placebo-controlled test. Patients were catheterized, but half didn’t actually get a stent. The result? No significant difference in exercise time or symptom relief. The improvement patients had reported for years appeared to be largely a placebo effect. One researcher described it as a “powerful placebo effect to the procedure.” ORBITA-2 did find some symptom benefit, but the original findings forced the entire field to ask: how much of what we believed was real, and how much was the patient’s brain doing the work? (1) (1)
Ten unnecessary surgeries that science has seriously questioned, and in many cases, debunked for certain patients. This doesn’t mean you should refuse surgery. But it does mean you should ask questions, get a second opinion, and ask about alternatives.
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