What Are The Surgical Options?

Philadelphia 76ers center Joel Embiid is out for the remainder of the 2024-25 NBA season due to ongoing issues with his left knee. Last month, the team announced that the NBA’s 2022-3 MVP might require another surgical procedure on his meniscus. The meniscus is a crucial piece of cartilage that acts as a shock absorber between the thigh bone (femur) and shin bone (tibia), allowing for smooth movement and stability.

Embiid first tore his meniscus in 2017, underwent surgery and returned to play. He experienced further issues in 2023 and 2024, leading to another meniscus surgery in 2024. Since then, he has battled ongoing knee pain and swelling. Given his towering 7-foot, 280-pound frame, the demands of professional basketball and his history of persistent knee problems despite multiple surgeries, Embiid’s condition is especially concerning.

According to ESPN insiders, further intervention is needed. The potential surgical approaches include:

1. Meniscus Repair

Although Embiid has already undergone two meniscus surgeries, one option is to attempt another repair. This would involve inserting a camera and surgical instruments into the knee, clearing out debris, removing irreversibly damaged portions and repairing what remains viable. However, given his history, another repair may not provide a lasting solution.

His surgeons must also determine why previous repairs failed. Repeated meniscus surgeries can leave the remaining tissue significantly reduced or degenerated, making successful repair less likely. The location of the damage is also crucial — while the outer part of the meniscus has a blood supply and can heal, the inner portion does not, making recovery more difficult if that area is affected.

2. Meniscus Transplant

A more aggressive option is a meniscus transplant, where a donor meniscus replaces the damaged tissue. This procedure is generally considered for individuals who have undergone a meniscectomy and continue to experience pain, early arthritis or recurrent swelling due to inadequate shock absorption. Whether these additional factors apply to Embiid is unclear from public reports.

Meniscus transplants are rare among elite athletes because recovery can take nine to 12 months or longer, with no guarantee the new meniscus will withstand the rigors of NBA play. Additionally, Embiid’s size and playing style — marked by quick cuts, explosive movements and heavy minutes in the paint — make this a potentially riskier option.

3. Osteotomy (Realigning the Knee)

The third option mentioned by ESPN is an osteotomy, a procedure that involves surgically breaking and realigning the knee bones to shift pressure away from the damaged area. This is typically considered for patients with persistent pain after multiple meniscus surgeries, especially if their knee biomechanics are placing excessive stress on one side of the joint.

An osteotomy can help redistribute weight more evenly, potentially delaying the progression of arthritis. Depending on the specific issue, it may involve adjusting either the femur (thigh bone) or tibia (shin bone). However, like a meniscus transplant, this procedure requires a prolonged recovery period of six to 12 months.

Embiid’s Long-Term Outlook

The decision on which procedure Embiid undergoes will depend on his medical team’s assessment of his knee’s anatomy, including the health of the meniscus and surrounding ligaments, his biomechanics, his ability to endure another lengthy rehab process and his long-term career aspirations. A meniscus repair might allow for the quickest return, but given his history, it may not provide lasting relief. A meniscus transplant or osteotomy could offer a more comprehensive solution but come with higher risks, particularly for an NBA player of his stature.

The 76ers’ championship hopes take a major hit without Embiid, and his durability remains a concern. For Embiid, this is another frustrating chapter in an otherwise brilliant but injury-plagued career. He has repeatedly proven his ability to overcome setbacks, but at nearly 31 years old, he and his team must now weigh the urgency of returning to the court against the importance of preserving his long-term health.

The road ahead will be challenging, but one thing is certain: Joel Embiid’s next decision will shape both his career and his quality of life beyond basketball.