One hundred and forty-six patients 35–65 years of age with knee symptoms consistent with a degenerative medial meniscus tear were randomized into receiving arthroscopic partial meniscectomy (APM) or a sham surgery (diagnostic knee arthroscopy). Primary outcomes of interest included radiographic knee osteoarthritis through using the Kellgren and Lawrence knee osteoarthritis grading and the Osteoarthritis Research Society International (OARSI) instrument, as well as patient-related outcomes via the Western Ontario Meniscal Evaluation Tool (WOMET), the Lysholm knee score, and knee pain after exercise. Outcomes of interest were assessed 5 years post-operation. No significant differences between the APM and placebo groups were observed in all three patient-relevant outcomes, 5 years post-operation. A slight increase in the risk of radiographic knee osteoarthritis progression was observed in the APM group, however this was not significantly different. A significantly higher risk of mechanical symptoms was observed in the APM group. Otherwise, outcome comparisons were similar between the two groups.