Orthopedics Hip & Knee Surgical Procedures 5 Long-Term Problems After Meniscus Surgery By Jonathan Cluett, MD Updated on June 01, 2023 Medically reviewed by Stuart Hershman, MD Print Table of Contents View All Table of Contents What Is the Meniscus? Long-Term Problems Long-Term Treatment Alternatives to Surgery Although arthroscopic surgery of the meniscus is minimally invasive, you may still experience knee pain after surgery. For some people, other problems can occur after surgery, such as arthritis, re-injury, incomplete rehabilitation, and more. This article explores the potential long-term problems after meniscus surgery. aabejon / Getty Images A review of 27 studies concluded that repairing the meniscus has a failure rate of 19.5% five or more years after surgery. What Is the Meniscus? The meniscus is a c-shaped rubbery cartilage that works as a shock absorber between the tibia (shin bone) and the femur (thigh bone). It provides stability to the knee and protects the lower leg from the load created by your body weight. How long does it take to recover from meniscus surgery? Recovery time will depend on several factors, including the extent of the injury, type of repair done, and your daily activity level. Usual recovery time is 4-6 weeks, and up to 6 months for more complicated repair surgery. Long-Term Problems After Meniscus Surgery There are several potential long-term problems that can develop years after meniscus surgery. Knee Pain People sometimes develop knee pain well after recovering from meniscus surgery. Some of the causes of long-term knee pain include: Persistent swelling or inflammationInfection (though this is rare)Difficulties with postsurgical rehabilitationRe-injuring the cartilageDeveloping arthritis 2:07 Click Play to Learn More About Knee Pain After Meniscus Surgery This video has been medically reviewed by Oluseun Olufade, MD. Arthritis in the Joint The type of meniscus surgery may make a difference in how likely it is that someone develops arthritis years later. A partial meniscectomy involves removing only the torn portion of the meniscus, whereas a full meniscectomy involves removing the entire meniscus to help reduce pain. Full removal of the meniscus has a higher risk of developing osteoarthritis (OA). Arthroscopy is rarely recommended for people with osteoarthritis (OA) in the knee because arthroscopy has not been shown to relieve the pain associated with cartilage damage caused by OA. Damaged Meniscus Having had surgery to repair a torn meniscus may make people more likely to have meniscus tears or other meniscus injuries in the future. Each knee has a lateral meniscus (on the outer side of the knee) and a medial meniscus (on the inner side of the knee). Depending on which meniscus is repaired, there may be a greater risk of re-injury. A 2020 study reported that 36% of medial meniscus surgeries required a repeat meniscus repair or partial removal of the meniscus after five or more years. Other factors that can increase the risk of a re-tear include being older and playing contact sports. Difficulty Walking With knee pain before or after surgery, you may unknowingly limp or develop an abnormal gait (the manner in which you walk) in order to protect the joint and reduce pain. Physical therapy, or rehabilitation, may be necessary after meniscus surgery to correct a limp, gait issues, or other problems with knee function once the surgery is done. Rehabilitation programs usually last four to six weeks and are designed to help improve joint strength, stability, and mobility. Correcting these issues is important to prevent further injury. Physical therapists warn that insufficient rehabilitation can be a cause of persistent knee pain after an injury. Examples of insufficient rehabilitation include: Missing physical therapy appointmentsNot doing necessary exercises as recommendedReturning to certain physical activities too soon Initial Exercises After Knee Arthroscopy Spontaneous Osteonecrosis Spontaneous osteonecrosis of the knee, or SONK, is a condition that causes a lack of blood supply to the bone. Osteo means "bone" and "necrosis" means "tissue death." This complication of knee arthroscopy 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, persistent pain, typically along the inner (medial) side of the knee. The pain is typically worsened by activity and relieved by rest. SONK is most often found in middle-aged women. Treatment of SONK can be very frustrating. Many patients find the pain is worse than the pain they had before arthroscopy. While the pain eventually settles down, often the only way to find relief is 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 a full knee replacement. How Is a Long-Term Meniscus Injury Treated? The treatment will depend on a number of factors, including: Your ageYour symptomsYour activity levelType, size, and location of the injury If someone underwent a surgical meniscus repair and still experiences pain and swelling, or if a re-tear occurs in the cartilage, a revision meniscus repair may be necessary if non-surgical options don't provide relief. If it's determined that surgery is needed, treatment may involve: Partial meniscectomy: The damaged meniscus tissue is trimmed off. This procedure usually allows for immediate weight bearing, and full range of motion soon after surgery. Meniscus repair: This procedure involves stitching the torn cartilage pieces together to repair it. Whether this procedure can be done depends on the type of tear and the overall condition of the injured meniscus. Because the meniscus must heal back together, recovery time for a repair is longer than for a partial meniscectomy. Physical therapy: Once the initial healing is complete, your healthcare provider will provide rehabilitation exercises or refer you to a physical therapist. You will start with exercises to improve your range of motion and then strengthening exercises will gradually be added. Rehabilitation time for a meniscectomy is about three to six weeks, while a meniscus repair is about three to six months. Alternatives to Surgery Many times surgery is not always needed to heal a meniscus injury. Non-surgical therapies may include: R.I.C.E. protocol is an initial treatment: Rest with modified activity. Apply ice or a cold pack to your knee for 15- to 20-minute sessions, several times a day. Compress your knee with a brace or knee sleeve to prevent additional swelling. Elevate your leg above your heart while icing it or whenever resting/relaxing. Nonsteroidal anti-inflammatory drugs (NSAID) can further reduce pain and swelling. A steroid (cortisone) injection into the knee joint is sometimes given to reduce inflammation and pain. Physical therapy after the R.I.C.E. protocol and other treatments can provide specific exercises to help restore optimal function in your knee. Summary Meniscus tears and injuries may require non-surgical treatments or arthroscopic surgery depending on the type and location of the injury and the overall condition of the cartilage. While this surgery is less invasive than other surgeries and often involves a quick recovery period, it doesn't always improve knee pain. Knee pain, osteoarthritis, re-injury, inadequate rehabilitation, and spontaneous osteonecrosis are potential long-term problems after meniscus surgery. Talk with your healthcare provider about treatments to help you find relief if you're experiencing pain or other post-surgery problems. Types of Knee Surgery 13 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. Friberger Pajalic K, Turkiewicz A, Englund M. Update on the risks of complications after knee arthroscopy. BMC Musculoskelet Disord. 2018;19(1):179. doi:10.1186/s12891-018-2102-y Nepple JJ, Block AM, Eisenberg MT, Palumbo NE, Wright RW. Meniscal Repair Outcomes at Greater Than 5 Years: A Systematic Review and Meta-Analysis. 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Clinical characteristics and treatment of spontaneous osteonecrosis of medial tibial plateau: a retrospective case study. Chinese Medical Journal. 2018;131(21):2544-2550. doi:10.4103/0366-6999.244113 Di Caprio F, Meringolo R, Navarra M, Mosca M, Ponziani L. Postarthroscopy osteonecrosis of the knee: current concepts. Joints. 2017;05(04):229-236. doi:10.1055/s-0037-1608666 Karim AR, Cherian JJ, Jauregui JJ, Pierce T, Mont MA. Osteonecrosis of the knee: review. Ann Transl Med. 2015;3(1):6. doi:10.3978/j.issn.2305-5839.2014.11.13 US National Library of Medicine. Meniscus tears - aftercare. Wilderman I, Berkovich R, Meaney C, Kleiner O, Perelman V. Meniscus-Targeted Injections for Chronic Knee Pain Due to Meniscal Tears or Degenerative Fraying: A Retrospective Study. J Ultrasound Med. 2019 Nov;38(11):2853-2859. doi:10.1002/jum.14987 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. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit