There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. If I could give more than 5 stars, I would. Identifying and properly treating meniscus tears (with or without surgery) will lead to the most rapid reduction in your symptoms and is crucial to optimize the long term health of your knee. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. This is because a lack of meniscus attachment at the root causes extra stress to be placed on an ACL graft and it can also result in the patient having more instability, both with anterior tibial translation, and with twisting and turning activities during the pivot shift, when there is a concurrent lateral meniscus root tear. 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. You can't walk right after surgery. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. We have published on several of these, noting that a PCL tunnel which is placed too close to the joint can detach the posterior horn of the medial meniscus and lead to the development of arthritis of the medial compartment. He and his staff could not have been more helpful and professional. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Yet, if you feel discomfort, you can take over-the-counter pain medication. We have published and validated our results in the peer-reviewed literature, which was at the time the largest series of meniscus root repairs reported. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. Being stronger is always better than being weak. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. If not treated, part of the meniscus may come loose and slip into the joint. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. If scar tissue is present, Dr. Nwachukwu will clean up the area so the knee is allowed to move through its entire range of motion. Does a extruded medial meniscus towards the posterior root need surgery? The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. Very reassuring, showed me X-rays and explained the healing process very clearly. I was adding 10 pounds a week for deadlifts but have now switched to pause deadlifts on Tuesday and add only 5 pounds a week to the heavy deadlift. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. 2018;47:762. Contact Dr. Nwachukwus team today! Procedure for Meniscus Root Repair. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. Most meniscus root tears require surgery. Thank you Dr. Burnham and Jerrica for everything! Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. Specializes in Orthopedic Reconstructive Surgery. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. Very thorough, knowledgeable and courteous. Phase I of Rehab: Surgery until 8 weeks. Well, this is not normal. Please try again. And slowly, I started bending the knee more, and eventually took the box away from my bench. If so, you may be at risk of tearing the root of your meniscus. It can also occur while bending the knee deeply. In terms of how, the transtibial technique has been felt to be the most effective way to pull the meniscus root back to its normal attachment site. dressing in 48 hrs and may let them drive The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. I could no longer deadlift from the floor, and was having trouble squatting below parallel. Lateral meniscus root tears can lead to arthritis, but they also result in the ACL being a little looser and the clunk that comes with an ACL tear (pivot shift) being more unstable. These include 1-tunnel and 2-tunnel techniques. 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. Normally, you should refrain from driving for at least 1 week after an arthroscopic knee operation, until the swelling reduces and the knee motion improves, but you should establish with your doctor when it is safe to start driving. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. <> Takes his time with you and doesn't hurry to rush out of the room if you have questions. The system also involves a drill with a cannula whereby one can drill through the tibial guide, see the drill bit come out inside the knee, and then pull the drill bit out and leave the cannula in place. Meniscus root repair rehab will usually start 1-2 days after surgery. . 4 0 obj If not even worse. My name is Dr. David Middaugh. After sutures are placed arthroscopically into the meniscal attachment, a small diameter tunnel, usually 5 millimeters in size, is reamed to the meniscal root attachment site, the sutures are pulled down the tunnel, and tied over a button on the anterior cortex of the tibia. I finally decided to make an appointment with a knee specialist. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. You may need surgery to restore full knee function. Theyre kind of done with you too but what if you want to go play with the grandkids do you want to kneel what do you want to exercise youve got to set your expectations to still take it easy still rehab or strengthen the right muscles or do the right kind of treatment for yourself so that you can continue to heal. This is because the signs of arthritis are usually pain and swelling with activities. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. Full recovery from meniscus surgery can take anywhere from six weeks to three months. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. The general published success rate for a meniscus root repair is between 80% and 85%. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. Dr. Burnham and his remarkable staff have been a godsend for our son. Robert LaPrade, MD, PhD 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. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. The length of time until patients are able to return to driving varies . This technique is fast and effective. I have two good arms, and a good leg. So its important at the very beginning its appropriate at the very beginning to make sure that all your emotions back and that you can do some simple walking to and from the house even though hurts so that youre not you know having accidents and better so youre not having emergencies happening you need the function of your leg back. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. When I returned home around 1pm that day, I sat in my living room for a bit, emailing and texting people to let them know I was alive and well. And they can get back to normal in about two or three months after having the surgery. I highly recommend Dr Burnham for your orthopedic needs hands down. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. Your knee will be swollen. This can occur with turning, twisting, or pivoting activities or sports. The next day, my left knee blew up to the size of a grapefruit. 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 procedure can be a complete meniscectomy where the meniscus and the . If one does a meniscus root repair in that extruded position, the chance of a meniscus root repair working over the long term is very minimal. Partial weightbearing status (<50%), unless otherwise ordered by MD. 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. We currently use UltraTape to do this. 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. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 while avoiding unnecessary surgery, injections, and medications. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . And thats the 80% fact is true that does happen. Meniscal Ramp Lesions. 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. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs can expect a variation of the following: Dr. Nwachukwu is extremely knowledgeable about his area of expertise. Two weeks. The technique of a meniscus root repair involves isolating the root, placing a minimum of 2 sutures in the remaining meniscal attachment, and trying to reposition it back to a more anatomic position. 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. No swelling. Ill def refer friends and family! A meniscus can become damaged due to sudden trauma. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. There was absolutely no knee pain. His team is prompt, thorough, and fun - always smiles. short distances based on their motion and His MA Michelle was very professional and kind. I can run, bike, & climb mountains. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. Heres the third practical tip if youre if you dont know where to go Ive got some exercises that i put on videos here for free on YouTube its linked in the description below theres one video in particular that i want you to take a look at its called top five glute exercises for knee problems go check out that video start doing those exercises youve got to exercise the heck out of your glutes if you got a meniscus injury if youve had a meniscus surgery in the past you need to get your glutes worked out. The pain is usually located one the sides or front of the knee, although it can occasionally be located in the back of the knee. One should assess the range of motion at that point in time that can be performed in a safe zone to make sure that the physical therapist does not flex them harder in this time frame. And Im a specialist physical therapist El Paso manual physical therapy. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. His staff is very friendly and upbeat, knowledgeable and thorough. I asked when I could start driving, and he said when I was off my pain medication. In patients who have open growth plates, consideration may be necessary to either plan to remove the sutures after the meniscus root repair heals or to consider placing the tunnels and suture repair above the growth plate such that is does not cross the growth plate and have a theoretical chance of causing a growth plate arrest. What made my recovery so fast? After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. Thanks to Dr. Burnham and his staff. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. El Paso, Texas 79903. 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. What was going to help my knee? But the next day, I woke up and literally ran down my stairs. Dr. Burnham was very personable and explained my situation in great detail. Patients are allowed to walk 4-6 weeks after surgery. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. United States. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. Wednesday: 8:00 am 5:00 pm 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. This allows the meniscus to heal back to the bone. You can schedule an office consultation with Dr. LaPrade. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. 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. I'm able to run and exercise without pain. The meniscus is a cushion of the knee joint. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. The most common method to fix meniscus root tears is through a tibial bone tunnel. The protocol is divided into phases. You will feel tired for several days. The most important thing as one gets older is the quality of the cartilage present. The following Tuesday, I saw my doctor. In some severe cases, they cant fully extend their knee out or bend their knee all the way. They are also important to the stability and function of the knee, keeping the meniscus in place. Patients \50 years had outcomes similar to those of patients !50 years, as did . For these, please consult a doctor (virtually or in person). endobj I walked around the gym with the crutches, and without the crutches. . In fact 2 years ago I finished climbing the top 100 peaks in CO. Repetitive motions, overuse, and muscular imbalances ar twitter.com/i/web/status/1, Digging Deeper into the Data: Is Suture Bridge Repair + #PRP really the best technique for #rotatorcuffrepair? twitter.com/i/web/status/1, Wild Life of the Last #BlackJockey to Rule the #KentuckyDerby The technique of a meniscus root repair involves isolating the root, placing a minimum of 2 sutures in the remaining meniscal attachment, and trying to reposition it back to a more anatomic position. The . Highlights from the StartingStrength Community. I really like and appreciate the time and effort he commits to research. (it is still a bit swollen). I was worried for my future with my legs letting me walk but she put me at ease letting me know she will do everything in her power to fix me or send me to whatever specialist I need to see to make sure I have a good chance walking in my future, and they all truly fantastic doctors. Begin passive range of motion exercises Start physical therapy or home exercise program 1-3 days after surgery Work on quad recruitment Brace/Crutch Use 25% weight bearing with crutches, brace 0-90 when ambulating and sleeping, can remove . And I feel my rode to recovery will be wonderful. The knee buckled and I thought, Shit. Strength. Kyle D. Morgenstern, MD . As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. Later that summer, the left knee began to bother meagain. You'll likely regain your previous muscle strength in the leg by. Therefore, we strongly advocate using a button to fix the meniscus sutures or tape on the tibia to minimize the chance of loosening over time. I switched from trap bar deadlifts to barbell rack pulls, continued to lower the box for squats and switched from single leg deadlifts to RDLs. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. Dr. Burnham clearly cares about his patients and their follow up care. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. My pain was gone. And this channel is dedicated to helping people stay healthy, active and mobile. The second step is to prepare a bony bed where the meniscus repair will be performed. They walked me through the process from beginning to end. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? Meniscal root avulsions are a challenging injury causing meniscal extrusion and loss of hoop stress distribution, which can lead to the development of knee arthritis.1 Securing the meniscus in a small bone socket has proven to be an effective means to restore hoop stresses and improve outcomes.2 The FlipCutter II reamer and meniscal root marking hook allow for a minimally invasive . 4010 W. 65th St. 3 0 obj GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . 2 0 obj 4. I have been very pleased with him at each visit..It's been almost 2 years since my meniscus root tear surgery and I have to say my knee feels great. Thanks to his staff for being so helpful. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. Rehabilitation begins within a week of surgery. Stated to me , in detail, what to expect and how long my recovery will take. A meniscus root tear requires the meniscus to be repaired back to the lower leg bone; this is also performed arthroscopically. You may need to leave a message. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. And now theyre kind of back to the way they were before the surgery. This is one of the first video demonstrations of this. It is our goal to provide the highest level of care and service to our patients. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. 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. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. Darin helped me understand that it was going to be a very slow recovery due to the nature of the surgery, and to be patient. Dr. Burnham took his time and answered all my questions with explanations. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. Please help. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. His extensive schooling, research, and commitment to his craft shined through at every turn as he evaluated my injury, presented all my options (clearly explaining non-surgical options and expected outcomes), and helped me plan my course of treatment and recovery. We are so grateful and thankful. There are two menisci in the knee, medial and lateral. But if we are stronger, we are harder to break, and we most certainly recover faster and better. They moved my knee a bit, and I had decent ROM, better than expected. Meniscus repair recovery While everyone's recovery is different, here's what you can typically expect with a repair surgery: You may be on crutches for four to six weeks. Country. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. Definitely recommend. The therapists were a little surprised to see me so soon after my surgery, but I really wanted to know how much range of motion I had post-surgery. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? Browse archives. This hoop stress is resisted by fibers that run circumferentially through the meniscus. Other factors can also be present with extrusion, including the progression of arthritis which can cause a well-done meniscus repair to extrude outside the joint. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. I felt very informed and well cared for. Recommend highly. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. I never met a doctor and his team that showed some much compassion about their patient. 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. Most patients will have pain with squatting and deep knee flexion with a root tear because a meniscus root tear occurs in the back of the knee. Sit at home on the couch and watch T.V.? My MRI showed an extensive radial tear adjacent to the medial meniscus root insertion, as well as evidence of high-grade chondral loss involving the central trochlea. very elderly patients). Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. The best surgeon is Baton Rouge that actually care about his patients!!! No, I didnt say pain free, or I didnt say get back to normal, just strong enough to get back to standing and walking because nobody wants to be in a wheelchair or not be able to get to the bathroom in time because of your knee not working right or being very painful.