5 Reasons for Continued Knee Pain After Arthroscopy

Arthroscopic knee surgery, also called a knee scope, is a surgical procedure used to manage and treat many common knee conditions, including cartilage injuries, meniscus tears, and ligament problems.

Because arthroscopic surgery is a minimally invasive technique that uses several small incisions rather than a large one, people tend to return to their activities more quickly and with less pain. But not everyone finds knee pain relief after surgery. Some people might struggle during the recovery more than expected.

Here are some top reasons why your knee may hurt after having a knee scope.


Click Play to Learn More About Knee Pain After Meniscus Surgery

This video has been medically reviewed by Oluseun Olufade, MD.


Persistent Swelling

knee swelling
aabejon / Getty Images

Arthroscopic surgery is a surgical procedure used to see inside your knee joint and repair or remove any damage. However, your body will still react to the trauma of surgery. In fact, some people have persistent swelling as a result of lingering inflammation from the surgery.

Persistent swelling is one of the most common symptoms after knee arthroscopy. Since there are many possible causes, swelling is often a difficult problem to solve.

If more serious problems related to surgery, such as infection, have been eliminated, treatments of swelling may include:

  • Ice application
  • Anti-inflammatory medications
  • Compression wraps and braces
  • Physical therapy


knee scope
Jodi Jacobson / Getty Images

Infection is an uncommon complication of arthroscopic surgery, but it is also the most feared by patients. Typical symptoms of infection include:

  • Persistent swelling
  • Warmth of the joint
  • Redness around the incisions or draining fluid
  • Fevers, chills, or sweats

If the infection is untreated, it can lead to serious issues. Infection can damage the cartilage tissue that protects bones in the joint, leading to the early onset of arthritis. The longer an infection persists, it can be more difficult to cure.

While infection isn't a common cause of pain after knee arthroscopy, it needs to be at the top of everyone's list. Early treatment is essential for the best chance at recovery. If the infection requires prolonged antibiotic treatment, it can require additional surgery to clean out the joint.


Inadequate Rehabilitation

meniscus repair rehab
Hero Images / Getty Images

When people have a knee injury, such as cartilage damage or a torn meniscus (the "cushions" inside the joint), they can develop poor mechanics of the knee joint. In order to protect the joint and reduce pain, people often limp or develop an abnormal gait. Your gait is the manner in which you walk.

Once the injury is taken care of, patients may need therapy to correct these problems with knee function. In addition, some knee joint injuries are the result of poor mechanics. Correcting these issues is important to prevent further injury.

Current research is focused on how sturdy your knee is when subjected to normal forces and movements. This is known as dynamic stability. Patients with dynamic instability may be more prone to injury and may require surgical treatment.

After surgery, your healthcare provider may recommend specific rehabilitation to address any weakness or gait abnormalities that may have caused an injury or resulted from an injury. Insufficient rehabilitation can be a cause of persistent knee pain after an injury.


Spontaneous Osteonecrosis

knee Mri
BSIP/UIG / Getty Images

One complication linked to knee arthroscopy is spontaneous osteonecrosis of the knee, or SONK. This condition is most often found in middle-aged women who have a knee arthroscopy. After their surgery, they develop persistent pain, typically along the inner (medial) side of the knee.

SONK is a condition that causes inflammation within the bone. Osteo means "bone" and "necrosis" means "tissue death."

SONK is thought to be the result of microscopic fractures of the bone around the knee joint. These fractures cause inflammation within the bone and significant pain. The pain is typically worsened by activity and relieved by rest.

Treatment of SONK can be very frustrating. Many patients find the pain worse than the pain they had before the arthroscopy.  While the pain eventually settles down, the only way to find relief is often to use crutches for weeks or months after knee arthroscopy.

Braces and medications can also help with the symptoms. In some patients, the symptoms can be so severe that they end up having either a partial knee replacement or full knee replacement.


Arthritis in the Joint

Young woman suffering from pain in knee, close up
Witthaya Prasongsin / Getty Images

Probably the most common reason why patients have persistent pain after arthroscopic knee surgery is that their knee has cartilage damage that can't be adequately repaired by an arthroscopic procedure.

It is well established that typical arthritis pain does not require arthroscopic surgery. Numerous studies have shown that the benefit of arthroscopy in these patients is no better than with nonsurgical treatments.

However, there are times when patients with osteoarthritis may have problems that can improve with arthroscopic surgery. Your surgeon may also not be aware of the extent of arthritis until the time of surgery.

Thus, people may have ongoing arthritis pain that does not improve despite the arthroscopic surgery procedure. The good news: There are many treatments for knee arthritis.


Arthroscopic knee surgery is often used to treat such knee conditions as meniscus tears and ligament problems. While the surgery is less invasive and often involves a quick recovery period, it doesn't always improve knee pain.

Swelling, infection, inadequate rehabilitation, spontaneous osteonecrosis, and arthritis in the joint are a few of the factors that cause continued knee pain after surgery. Luckily, there are a variety of treatments to help you find relief.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.