What Are the Long-Term Side Effects of Meniscus Surgery?

What is meniscus surgery?

The meniscus is two C-shaped pieces of cartilage that sit between the thigh bone (femur) and the shin bone (tibia) in each knee. There are two menisci in each knee: the medial meniscus on the inside and the lateral meniscus on the outside. The meniscus acts as a 'cushion' or shock absorber during high-impact activities, protecting the lower part of the leg.

Meniscus surgery is a procedure performed to treat a torn meniscus. The surgery is usually carried out arthroscopically, using small incisions and a camera to either trim away the damaged section (partial meniscectomy) or repair the tear with stitches.

In some cases, a doctor may recommend a full meniscectomy (removal of the entire meniscus), or a meniscus transplant if preserving the tissue isn't possible. The main goal is to relieve pain, restore function, and prevent further joint damage.

Long-term side effects of meniscus surgery

While meniscus surgery can provide significant relief and restore knee function, some patients may experience long-term side effects. Understanding these potential complications is crucial for making informed decisions about your treatment and recovery.

Chronic knee pain

Some individuals develop persistent knee pain months or even years after recovering from surgery. This can result from incomplete healing, premature return to activity or sports, re-injury of the knee, insufficient rehabilitation after surgery, or underlying joint issues.

Chronic pain may also be linked to the removal of too much cartilage, causing the knee bones to rub against each other; the acceleration of pre-existing knee osteoarthritis; nerve irritation; or ongoing inflammation within the knee.

Postoperative arthritis

Meniscus surgery, especially partial or total meniscectomy, can increase the risk of developing osteoarthritis in the affected knee. Removing meniscal tissue reduces the knee’s natural cushioning, leading to increased friction and wear on the joint surfaces over time.

Signs of arthritis, such as bone spurs and joint space narrowing, are more common in patients who have undergone meniscectomy. If you have pre-existing knee osteoarthritis, surgeons will aim to preserve as much cartilage as possible to avoid postoperative acceleration of the disease.

Meniscus reinjury

The risk of re-tearing the meniscus or injuring the remaining cartilage is higher after surgery, particularly in active individuals or those who return to sports too soon. This can occur when a partial meniscectomy thins areas of cartilage, creating weaknesses that can cause them to crack, split, or tear when placed under stress.

The likelihood of reinjury also depends on the type of surgery performed and the location of the original tear. Depending on the repair section of the meniscus, the risk varies. Repairs of the medial meniscus (on the inner side of the knee) pose a greater risk of reinjury than repairs of the lateral meniscus (on the outside of the knee).

Nerve damage

Nerves populate the knee joint, regulating movements and providing sensations like pain. These include the tibial nerve (which supplies the back of the knee), the obturator nerve (which supplies the inner knee), and the peroneal nerve (which supplies the front and outer knee).

Although rare, nerve damage can occur during meniscus surgery. This may result in numbness, tingling, or ongoing pain in the knee or surrounding areas. Nerve injuries are more likely if there is excessive traction or surgical error.

An example would be nerve damage at the peroneal nerve, leading to decreased sensation in the knee, inner thigh, and groin. There may also be chronic nerve pain, paraesthesia (pins-and-needle sensations), and muscle weakness affecting your ability to walk or even stand for long periods.

Spontaneous osteonecrosis

Spontaneous osteonecrosis of the knee (SONK) happens when the blood supply to part of the knee bone is reduced, causing the tissue to weaken and, in rare cases, die.

SONK is a rare but serious complication that can cause persistent pain and may require further intervention.

This can occur after arthroscopic knee surgery when the removal of the meniscus increases weight-bearing stress on the knee and lower leg. The overloading of the joint can, in turn, lead to the compression of blood vessels that supply the bones of the knee. The medial (inner) meniscus is most commonly affected.

Symptoms of SONK include:

• Sudden onset of severe knee pain

• Loss of range of motion of the knee due to pain

• Swelling and tenderness

• Fluid overload in the knee

• Activity typically exacerbates the pain, while rest alleviates it.

SONK often goes away on its own when using crutches to reduce vascular compression. Severe cases can cause major bone loss, requiring either a partial or total knee replacement.

Muscle weakness and imbalance

Long-term muscle weakness, particularly in the quadriceps and surrounding muscles, can develop if rehabilitation is incomplete or delayed. Muscle imbalance may contribute to ongoing pain, instability, and increased risk of further injury.

Muscle weakness and imbalance may also lead to the reinjury of the meniscus if not addressed with early intervention.

If you are concerned with any of the above long-term side effects after your meniscus surgery, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.

How is a long-term meniscus injury treated?

Treatment for long-term complications following meniscus surgery depends on the specific issue and several factors, such as:

• Your age

• Your weight

• Your general health and mobility status

• The type, size, and location of injury

Potential treatments will also include:

• Physiotherapy:

  • Physiotherapy involves targeted exercises aimed at strengthening muscles, improving flexibility, and restoring function.

• Pain management:

  • Medications, injections, or other therapies to control chronic pain.

• Surgical revision:

  • In cases of reinjury, failed repair, or severe arthritis, further surgery may be necessary.

• Lifestyle modifications:

  • Weight management and activity adjustments to reduce joint stress.

Alternatives to meniscus surgery

blNot all meniscus injuries require surgery. Alternatives include:

• Rest, Ice, Compression, Elevation (RICE):

  • RICE alleviates inflammation, swelling, and pain in the initial phases of recuperation.

• Physiotherapy and rehabilitation:

  • Strengthening and stretching exercises to support the knee.

• Medications:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers such as ibuprofen and naproxen can provide temporary relief.

• Injections:

  • Injections such as corticosteroids or hyaluronic acid can reduce inflammation and improve joint lubrication.

• Activity modification:

  • Steer clear of high-impact activities to avert additional harm.

The information provided is intended for general guidance only and should not be considered medical advice. If you are interested in alternatives to surgery, please consult a specialist for personalised recommendations and tailored advice. Request an appointment with Thomson Medical today.

FAQ

Will my knee ever be the same after meniscus surgery?

Many people regain excellent function and experience pain relief after meniscus surgery, but some may notice ongoing symptoms or reduced performance, especially if significant meniscal tissue was removed or arthritis develops later.

Why does my thigh hurt after meniscus surgery?

Thigh pain can result from muscle weakness, nerve irritation, or compensation during movement. It is often related to incomplete rehabilitation or altered gait patterns following surgery.

How long does it take to recover and recuperate after meniscus surgery?

Recovery time varies: partial meniscectomy usually takes 4–6 weeks, meniscus repair can take 3–6 months, and meniscus replacement may require up to a year. Full recovery depends on the type of surgery and adherence to rehabilitation.

What is the fastest way to recover from meniscus surgery?

Follow your surgeon’s and physiotherapist’s instructions, attend all rehabilitation sessions, and avoid returning to high-impact activities too soon. Gradual progression and consistent exercise are key to optimal recovery.

Is it normal to have pain in the back of the knee after meniscus surgery?

Some discomfort, including pain at the back of the knee, is common during the early stages of recovery. Persistent or severe pain should be evaluated by your healthcare provider to rule out complications.

When will my knee feel normal after meniscus surgery?

Most patients see significant improvement within a few months, but complete recovery can take up to a year, especially after a repair or replacement. Ongoing symptoms should be discussed with your orthopaedic specialist.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.