Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. My name is Dr. David Middaugh. The most common root repair technique is called a transtibial technique. It takes longer for a meniscus repair to heal than a meniscectomy. Each week my leg brace is put to a different degree so I learn to bend my knee again. At the beginning of April, I was dancing at a friends wedding when I suddenly heard and felt a loud pop in my left knee. EDINA- CROSSTOWN OFFICE This allows the meniscus to heal back to the bone. It was tough, and it hurt like hell, but I took it slowly. I decided right then and there I would not get the MRI. In terms of when, one should plan to perform a meniscus root repair as soon as it is diagnosed as long as ones articular cartilage is still fairly intact. And now theyre kind of back to the way they were before the surgery. He provided a thorough explanation without wasting time. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. I did a few jungle gym rows, and finished with planks. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . We currently use UltraTape to do this. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Very positive experience at Bone and Joint Clinic in Baton Rouge. For these, please consult a doctor (virtually or in person). We had a wonderful experience and I highly recommend him. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. I hope that you found hope now that if you got if you had a meniscus surgery in the past and youre dealing with these problems of swelling the pain the loss of motion please start doing this this taking this advice that i gave you start doing the exercises and get better it is possible to get that swelling down and to get your motion back and to recover and be normal. I have now biked five to six days each week since my surgery. His team is prompt, thorough, and fun - always smiles. Figure 5:: Cortical fixation of transtibial meniscal root repair. Do minor meniscus tears require surgery or can it repair itself? PDF Meniscal Root Repair Post-operative Rehabilitation Protocol Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. After Meniscus Surgery: What To Expect In The First Few Days And Weeks In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. The second tip i need you to take home today is you need to listen to your knee because after youre on your own and youre youre supposed to be 80% better theres things that youll be able to do and go ahead and do those as long as they dont hurt or bother you or cause some effects later on that day or the next day then theyre generally going to be okay things for you to do you can probably do some walking but walking you know a few miles maybe not very comfortable for you that may set off the swelling that may hurt you more. Does having a cortisone shot help a meniscus tear or is surgery the only option? In some cases, its important that you take away from this video today that it takes six to 12 months to heal from a meniscus surgery. In determining if one can have a revision root repair, one needs to determine the cause of the failure as well as the amount of underlying arthritis. Being stronger is always better than being weak. Heel lift in opposite shoe to normalize gait. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. Meniscus Root Repair | Orthopedic Knee Surgeon | Vail, Aspen, Denver A meniscus root tear occurs when one or both of these roots tear away from the bone. Strength is one of the most important aspects of our lives. Your subscription could not be saved. I would recommend his service to any recreational athlete. One of the most common is in patients who may have some underlying arthritis and the arthritis is causing the pain or the arthritis has progressed further after the meniscus root repair. The study included 351 patients with knee OA and meniscus tear. Further study into meniscus root tears and radial root tears is ongoing by our research laboratory to try to improve the treatment of these complex problems. In radiologic terms, this is called a bony ossicle. The technique for a repair for a bony avulsion, called a type 5 meniscus root tear, is similar to the other techniques other than it should have the bone piece shaved down and cleaned off such that it can be pulled back into the area where it had been avulsed from. PDF Knee meniscus root repair - tcomn.com Untreated meniscus tears can increase in size and lead to complications, such as arthritis. Meniscal Root Tears - Dr. Chris Jones Colorado Springs, CO My calf swelled up into my ankles. Thank you Dr. Burnham for being so amazing! Dr. Burnham performed my hip pin surgery and it all went extremely well. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. I went to Dr. Burnham for issues I was having with my shoulders. Thus, when one does sustain a lateral meniscus root tear with an ACL tear, consideration should be given to having a concurrent lateral meniscus root repair so the ACL graft does not stretch out. It helps to be strong, my PT remarked. It was glorious. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Rehabilitation Following Meniscal Root Repair: A Clinical - JOSPT Meniscus tears & repairs - Overview - Mayo Clinic Orthopedics & Sports My name is Dr. David Middaugh. Please try again. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. This can occur in up to 20% of patients, even in the best of circumstances. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. Arthrex - Meniscal Root Repair I walked around the gym with the crutches, and without the crutches. Kyle D. Morgenstern, MD . Meniscus Root Repair & Recovery | Emily Socolinsky - Starting Strength 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. This may be recommended depending on the type of meniscus tear. If youre watching this video today, and youre considering having a meniscus surgery for your knee, then youll want to listen closely so that you dont make this mistake after you have your meniscus surgery. I am so glad I did! The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. I would have relied strictly on physical therapy. Appreciate the attention and time spent during office visits. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. He then drills a hole from the front of the tibia, into the root area and brings the sutures through the hole in order to tie them together and hold the tissue in place. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. I have see all three orthopedic doctors at the Grove and Jerrica is the one I see the most and the latest she's absolutely wonderful. I could no longer deadlift from the floor, and was having trouble squatting below parallel. So that means youre good to go after two to three months. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. During our biomechanical testing, we found that if we tied the sutures directly over bone, with cyclic loading, the sutures would cut into the bone and the repair would become loose over time. And people are often disappointed to find out that as they begin to get back to normal, as theyve been told that they probably could and should they start to get swelling in the knee, they start to get a pain, of course. I really like and appreciate the time and effort he commits to research. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. You can schedule an office consultation with Dr. LaPrade. Therefore, the patient should be worked up in a timely fashion when they do have a posterior horn medial meniscus root tear to determine if they are a candidate for a posterior horn medial meniscus transtibial root repair. The next day, my left knee blew up to the size of a grapefruit. If one has too much arthritis, then the chance of a meniscus root repair helping one to slow down the progression of arthritis is probably not worth having the meniscus root repaired. There are some isolated reports of using suture anchors to repair a meniscus root repair, but this area of the knee is very difficult to access and the suture anchors can leave large knots which could subsequently interfere with the cartilage surfaces in the knee. I kept training, modifying my squatting as needed until I could get back to proper depth. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. I decided to continue with my usual four day split with two upper body days and two lower body days, although I did also incorporate a few extra upper body exercises as my lower body work was not that intense. Meniscus Tears: Why You Should Not Let Them Go Untreated The other aspect that needs to be evaluated is the amount of extrusion of the meniscus. Realize that, as discussed above, the torn part of your meniscus was removed. If it is your right knee, it will be at least a week before you can drive, as it would be risky to have to hit the break too soon after surgery, and you would be a risk to yourself and everyone else on the road. When I woke up I was in significant pain but the nurses had it under control by the time I left. Dr. Burnham took his time and answered all my questions with explanations. If you're an athlete needing a doctor that understands; this is the guy. Phase I of Rehab: Surgery until 8 weeks. My 14 year old son originally went in to see Dr. Burnham very scared (he hadn't had an injury before) and he was instantly made to feel at ease. The most important aspect to assess when one is looking at a root repair is to ensure that ones cartilage surfaces are still fairly normal. In this technique, sutures are placed into the torn meniscus root and then shuttled down tunnels in the tibia to tie the repair into place. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. The most common complication after a meniscus root repair is a re-tear. It is vital that meniscus repair patients do not squat for at least four months after the repair. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. In particular, it has been found that one of the most common reasons why younger patients need total knee replacements is because of a neglected or undiagnosed meniscus root tear leading to the development of osteoarthritis. And its a lot slower for the remaining, you know, six to nine months after the first two or three months. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. Call your doctor or 911 if you think you may have a medical emergency. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Meniscus root tears - a devastating injury - Dr. Bu Balalla while avoiding unnecessary surgery, injections, and medications. He listens and address every concern with appropriate solutions. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. Sit at home on the couch and watch T.V.? Well, this is not normal. If one has fairly normal cartilage of that side, the success rate is going to be better than those patients that have mild to moderate chondromalacia (arthritis) of the same compartment as the root repair. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the dressing in 48 hrs and may let them drive He spent a great amount of time explaining everything to me in a way that I understood everything. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. I got a lift home, and returned to the gym later that evening for more coaching. I opened my gym shortly after taking up strength training in earnest to help address my back pain, and have been working for the past eight years to help others embrace their true potential and strength. I finally decided to make an appointment with a knee specialist. Meniscus Tear Surgery Recovery Time: When Can I Get Back to Work? More diffuse pain over the inside of the knee which becomes progressive over time can be particular ominous because this may mean that the cartilage is wearing out fast or that one has an insufficiency fracture or spontaneous osteonecrosis of the knee, occurring due to the fact that the meniscus is such an important shock absorber. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. The knee will be swollen for 2-3 months. Highlights from the StartingStrength Community. Oftentimes healthcare providers will tell you go walk your knees operated on its good youre the we took out the chunk that was you know causing your need to lock up the meniscus we did a meniscectomy or we repaired the meniscus and its all sewn together now so you can go ahead and walk all you want and some people take that to heart and to go walk you know three miles a day or even 10-20 miles a week and their meniscus just doesnt heal enough and they get that swelling. amount of, supply and beyond the age of 15 has limited healing without surgery. They are connected to your tibia by meniscal roots. So happy I found them! I got rid of the box for squats the end of July. I also found that there were patients being referred to me who had meniscus root repairs that were done well, but the meniscus was not pulled back in the joint and these patients continued to have pain. First, one needs to ensure that the meniscus root is repairable and that there is not too much arthritis on that affected portion of the joint such that a meniscus root repair would not be recommended. 3 0 obj Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . United States. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Monday: 8:00 am 5:00 pm General anesthesia and a nerve block. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. I chose not to use my crutches anymore. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. I felt very informed and well cared for. And Im a specialist physical therapist El Paso manual physical therapy. Many meniscus tears can be treated successfully without surgery. (Please keep reading below for more information on this treatment.). Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. The most important thing as one gets older is the quality of the cartilage present. Meniscal Repair. Types of root tears: The mini First-Pass device allows placement of either a suture or an UltraTape through the substance of the meniscus, capturing the end of the stitch as it is placed through the meniscus and then it can be pulled out of the joint. They are also important to the stability and function of the knee, keeping the meniscus in place. An iatrogenic meniscus root tear means that a tunnel was drilled for an ACL or PCL reconstruction and hit the meniscus root and detached it from bone. A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. 515 Ray C. Hunt Drive, Suite 1100, Charlottesville, VA 22903 Phone: 434-243-7778 Fax: 434-243-5075 Meniscal Root Repair Post-operative Rehabilitation Protocol. It can also occur while bending the knee deeply. %PDF-1.5 Placing sutures or UltraTape on each side of the tear and pulling it down into tunnels should be a safe and reliable method for a bony avulsion root repair. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. There are many factors that go into this, including a patients weight, with overweight patients putting more stress on the meniscus root tear, ones alignment, where one being bowlegged with a medial meniscus root repair putting extra stress on the repair, and also the amount of underlying arthritis present prior to the root repair. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. I was going to rehab myself, and keep training as normally as I could. Now, the focus when you go into a surgeons office, theyre looking at your MRI, theyre looking at your meniscus on the MRI, theyre telling you the tear in the way that its torn and how theyre going to repair it. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. No swelling. His surgery and recovery has been perfect! Procedure for Meniscus Root Repair. Therefore, we then looked at surgical techniques and due to the fact that we had multiple second look arthroscopies after bone grafting for ACL reconstructions with meniscus root tears, that the 1-tunnel technique had more of a spot welding healing of the meniscus to bone whereas the 2-tunnel meniscus root repair technique had a much better healing surface of the meniscus to bone. Partial weightbearing status (<50%), unless otherwise ordered by MD. We love you! Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. A torn meniscus can result in either sudden or gradual onset of pain. That means that the remaining meniscus is smaller, but still taking the same pressure. So go check out that video on how to exercise your glutes theres five exercises in there that you can start doing them i would do them every day i do them a couple times a day even more if you can i would do what you can tolerate without it being too much soreness and your glute muscles and they should all generally be okay on your knee theres some where you got to kneel you can adjust it you can not do that exercise if you want. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. My surgery was at 8:30am Wednesday, February 20. At the end of March, my doctor told me I could take my brace off completely, and use crutches for another week if I needed to. In some severe cases, they cant fully extend their knee out or bend their knee all the way. You should also be able use your leg for driving after one to two weeks, as long as you're not taking opiate pain medication. Dr. Burnham made sure I knew what was happening and what could happen. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. I recommend him, as well as his staff, to anyone requiring such services. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. And thats all good if youre going to end up having the surgery. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. A written consent will be obtained from you after the surgical procedure has been explained in detail. Many surgeons will tie the meniscus root repair with the knee bent, so that one can start motion right after surgery and not have to worry about the meniscus root repair being stretched out. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. I'm able to run and exercise without pain. One should not look at age as a factor for meniscus root repairs. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. Dr. Burnham has an awesome bedside manner. 1 doctor answer 2 doctors weighed in Dr. Jeffrey Sider answered Sports Medicine 41 years experience Depends: If surgery is on the left leg i let some patients drive the next day if they feel ok. Treating a Meniscus Tear With Physical Therapy - Verywell Health When you put weight on your leg, it is the meniscal roots that transfer the axial loading forces of the knee into hoop stress in the meniscus. A meniscus root tear usually will not heal on its own. He will now be caring for my hip and knee in the future. Many surgeons will tie the meniscus root repair with the knee bent, so that one can start motion right after surgery and not have to worry about the meniscus root repair being stretched out. A week later, I got my MRI results and I was told that this was going to be a very long recovery, but I had other plans. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. It hurt like hell. Meniscal Root Repair | Knee Specialist | Minnesota I press and bench with no modifications. Other sources of pain can include scarring within the joint that occurs as a normal part of a surgical procedure, or pain from other pathology and joint, such as arthritis under the kneecap. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. Really cares for his patients! This step involves making a surgical incision or extending a previous surgical incision (such as with an ACL reconstruction) and ensuring that one is dissected down directly to bone. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. We recommend the use of 2 cannulas such that the meniscus can be pulled down over a broader area and have a better chance of healing to the bone. I started Brazilian Jiu-Jitsu about four years ago. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. So you need to just have that expectation right now if youre going to go get a surgery, or if youve already had one, if its been more than six months, or youre in that you know, past six months, six to 12 months range or longer since your meniscus surgery, then its okay as long as you dont have another tear or some other massive injury to it, you can probably get that swelling under control, regain your motion back as long as it hasnt been too long. . 2601 E. Yandell Drive, Suite 232 There are two menisci in the knee, medial and lateral. Then, in January of 2018, while warming up in class one morning, a sharp, nauseating pain shot through my left knee, which made me start limping. But youre also not alone. Dr Burnhams bedside manner was exceptional. There goes my knee again.. The exception is a patient that has contra-indications to surgery or already has too much cartilage wear and tear for the root repair to be beneficial. The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. Patient Testimonials - Meniscus Root Repair Everett | OCD Repair of the Meniscus Root Tear Repair | Orthopedic Knee Surgeon | Manhattan, New The Biggest Mistake People Make After Knee Meniscus Surgery If the patient has or has developed significant arthritis, which is usually designated at Kellgren-Lawrence grades 3 or 4, it is felt that a revision root repair may not be indicated. Both my children have seen Dr. Burnham with great results.
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