cccs, sorry about you knee. There are studies that suggest that the bisphosphonates have protective effect against degradation in the knee, but others suggesting that bisphosphonates have deleterious effect.
There isn't enough research to warn us or encourage us.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11505443/
The mechanism of action is thought to be that aminobisphosphonates transiently stimulate the production of proinflammatory cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha.
https://pubmed.ncbi.nlm.nih.gov/16755241/.
https://www.sciencedirect.com/science/article/pii/S1063458420310864
from communication with an endocrinologis who oversaw the Reclast trials.
"When amino-bisphosphonates (N-BPs) are administered IV, resulting in a high systemic exposure (unlike when taken orally, where the very low oral bioavailability results in a quite low systemic exposure), phagocytic cells other than just osteoclasts can encounter the N-BP, Up to 30% of patients can experience an APR (acute phase reaction) after their initial infusion of zoledronic acid. This APR, which starts usually about 6 hours post-infusion, and can last several days, consists of a mild fever associated with muscle and joint pains, similar to the symptoms with a bad viral infection such as the flu. And it turns out that the cause is very similar, as well. When a special category of phagocytic T-cells, called gamma-delta T-cells, encounter the zoledronic acid, they engulf it, just like an osteoclast will engulf alendronate or zoledronic bound to the bone surface. And just like an osteoclast that engulfs a N_BP undergoes apoptosis (programmed cell death), the gamma-delta T-cells that engulfs a N-BP also undergoes apoptosis. The difference is, when a gamma-delta T-cell undergoes apoptosis, it releases inflammatory cytokines, such as IL-1, IL-6, and TNF-alpha, just like when it encounters a flu virus. And these inflammatory cytokines mediate the temperature rise and myalgias, just as with a flu infection."
I think that this https://pmc.ncbi.nlm.nih.gov/articles/PMC8373857/.
article might explain the longer term consequences for some on this and other medications.