Proper fixation of the meniscal root can prevent or slow down the development of arthritis in that area of the knee. 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. We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. He is walking without a limb and is on schedule with his progress. My name is Dr. David Middaugh. 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. 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 procedure can be a complete meniscectomy where the meniscus and the . And its really concerning and very disappointing for somebody whos gone through the knee surgery. 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. This results in premature arthritis and cartilage damage in the knee. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. I went to Dr. Burnham for issues I was having with my shoulders. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. 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. Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . Phase I of Rehab: Surgery until 8 weeks. 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. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. Hands down would recommend him!! Your care after surgery may involve: Crutches to take stress off the knee as it heals. But its just not common knowledge to take six to 12 months to heal after a meniscus surgery. Fortunately, this is usually done arthroscopically and with good results. You will begin to focus on regaining your ROM and begin more in muscle strengthening. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Knee popping after meniscus surgery can occur due to fluid accumulation, scar tissue, swelling and stretching of the tendon and ligaments, weakened leg muscles, changes in patellar tracking, underlying knee arthritis, unstable meniscus, and inflamed plica. Dr. Burnham took his time and answered all my questions with explanations. Very positive experience at Bone and Joint Clinic in Baton Rouge. The following Tuesday, I saw my doctor. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Meniscus root repair surgeon, Doctor Benedict Nwachukwu provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, New York City, NY who need meniscus root repair surgery. If not even worse. Are you a candidate for a meniscal root repair? Timeline: 1 week to 5 weeks after Surgery. In addition, we looked at varying suture techniques through the meniscus, including 2 simple sutures, as well as other configurations of meniscus suture techniques, which are more complex. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the Please subscribe to this channel and turn on your notifications so that you dont miss a single video with great tips and advice that we put out every single week. Realize that, as discussed above, the torn part of your meniscus was removed. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. I started Brazilian Jiu-Jitsu about four years ago. This specific type of tear makes up 90% of all meniscal root tears. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. % So lets get to it. Knows his stuff. It is shaped like a C and it serves to cushion and stabilize the knee. Return to Sport after Meniscus Surgery Chicago, IL | Dr. Jorge Chahla Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. You will feel tired for several days. But now I know more about the body, about rehab, and about what being stronger really means. Using specific guides to ensure that one can place tunnels in the anatomic position and using self-capture devices, which have been devised to be small enough to not scuff up the cartilage, are some of the best means to perform a transtibial meniscus root repair with self-capture devices. If the surgery is on the right leg i change to His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. <> Meniscus root repair | Knee Problems | Forums | Patient However, we felt that with a 6-week period of being nonweightbearing important for all meniscus root tears, that the 2 simple suture technique was valid. 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. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. But theres still healing to be done and that 20% is really critical. A lateral meniscus root tear involves a tear of the meniscus either at or close to the root attachment in the back part of the lateral meniscus. This may be recommended depending on the type of meniscus tear. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. Unfortunately, as we have developed more scientific evidence for this, including several studies in my lab, we found that the lateral meniscus root is extremely important to both prevent the development of osteoarthritis over time and also to protect a concurrent ACL reconstruction graft. Strength is one of the most important aspects of our lives. Meniscal root tears: Solving the silent epidemic - Journal of Meniscal repair may be performed either by open surgery under direct vision or minimally invasively using an arthroscope that can be inserted into the knee through a very small key-hole incision to locate and repair the damaged meniscus. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. Meniscus Repair Surgery Rehab Protocol & Recovery Time - Kevin R. Stone Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. 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 possible cause for knee pain 1 year after meniscus surgery would be a re-tear of the meniscus. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. Meniscal Root Repair | Knee Specialist | Minnesota Usually, pain is minimal after this type of surgery. This technique is fast and effective. But you need to still continue doing a few things to make sure that you get that remaining 20% healed so that you can truly get back to normal so let me give you some practical advice here three things that i want you to take away from this video number one set your expectations. 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. If a patient does have a meniscus root tear and the cartilage in that same compartment is still relatively good or normal, a meniscus root repair would be indicated. Meniscus repair rehab protocol. The pain during my recovery has actually only been minimal, requiring no pain meds. If not treated, part of the meniscus may come loose and slip into the joint. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. This is done to protect the repair and let the body heal it. I have now biked five to six days each week since my surgery. Because this is a frequent question posed on Google, I will try to be modest in answering this. I highly recommend Dr Burnham for your orthopedic needs hands down. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. Driving after meniscus surgery EDINA- CROSSTOWN OFFICE 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. In January of this year, I finally decided to go back to my doctor to get that MRI. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Meniscal repair may be performed either by open surgery under direct vision or minimally invasively using an arthroscope that can be inserted into the knee through a very small key-hole incision to locate and repair the damaged meniscus. PDF Rehabilitation Guidelines for Meniscal Repair of Root and Complex Tears For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. while avoiding unnecessary surgery, injections, and medications. Meniscal Root Repair Kirkland | Meniscal Root Tear Seattle, Everett PDF Coronal extrusion of the lateral meniscus does not increase after This allows the meniscus to heal back to the bone. Amazing Doctor and wonderful staff!! Two weeks to the day, I got on my spin bike at the gym and did what I could do. If I could give more than 5 stars, I would. 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. Your knee will be swollen. Some patients may experience catching, clicking, or locking of their knee. 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. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. Meniscus root repair surgery recovery Most patients can return to full activity 4-6 months after a meniscus root repair. And then after the surgery, the focus is doing physical therapy, typically if he gets sent there, and youre going to lose some motion in the surgery so your knee wont be able to bend or straighten all the way. It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. 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. And this channel is dedicated to helping people stay healthy, active and mobile. This answers all my questions! Stated to me , in detail, what to expect and how long my recovery will take. 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. Meniscus Root Repair Rexburg ID | Meniscal Root Tears Rexburg ID I think my clients thought I had lost my mind, but what else was I going to do? I really like and appreciate the time and effort he commits to research. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. My pain was gone. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. One patient was noted to have an insufficiency fracture and spontaneous osteonecrosis of the knee (SONK) as part of the root tear and came in in a wheelchair and she has had6 years of successful return to activities after her meniscus root repair, including hiking and cycling. Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. Monday: 8:00 am 5:00 pm <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 12 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> It takes longer for a meniscus repair to heal than a meniscectomy. The aftercare and recovery require postoperative protection to allow healing. Medial Meniscus Posterior Root Repair Using a Transtibial Technique Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. 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 What could you eat or do for a meniscus tear to heal faster after surgery? Specializes in Orthopedic Reconstructive Surgery. Dr. Burnham was very helpful for my injury! Being aware of the location of the meniscal attachments at the time of ACL and PCL surgeries is essential to minimize the chance of an iatrogenic root tear. PDF Meniscus Root Repair Rehabilitation Protocol It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. (Please keep reading below for more information on this treatment.). The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. Can you tear your meniscus again after a surgery and if you do how can you tell? While there are a small number of patients who do have their meniscus root re-tear, this has been nowhere near as common as the other sources noted above. If you're an athlete needing a doctor that understands; this is the guy. Full recovery usually takes 6 months but can take up to 1 year. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. I felt very informed and well cared for. He will now be caring for my hip and knee in the future. Now my intent on this video is not to throw anybody under the bus surgeons are doing the best they can with what they know and saw our physical therapists in any health care providers that you may be seeing for your meniscus problem. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. Thanks to Dr. Burnham and his staff. Really a national leader in sports medicine! 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 . Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. PDF Knee Arthroscopy Meniscus Root Surgery FAQ - Twin Cities Orthopedics Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. 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. Meniscus root tears usually occur in patients with deep flexion such as skiers, or home gardeners, plumbers, or carpet layers or people doing similar activities. Your doctor put a lighted tubecalled an arthroscope or scopeand other surgical tools through small cuts (incisions) in your knee. Figure 5:: Cortical fixation of transtibial meniscal root repair. Nothing. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? In addition, the design of the meniscus is such that the full pressure of weight bearing activities is transmitted through the root of the meniscus, meaning that it is constantly pulling and stretching the tear with every step. He spent a great amount of time explaining everything to me in a way that I understood everything. 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. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. Most importantly, I have not missed a single coaching or training session since my surgery. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! How Long Is Recovery After a Meniscus Repair? 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. The length of time until patients are able to return to driving varies . I could no longer deadlift from the floor, and was having trouble squatting below parallel. You can't walk right after surgery. Treating a Meniscus Tear With Physical Therapy - Verywell Health 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. Kyle D. Morgenstern, MD . Patients \50 years had outcomes similar to those of patients !50 years, as did . And get the pain under control and recover normally the way that you should have once you start doing the right things. The protocol is divided into phases. Patients often report hearing a pop at the time of injury. Walk with crutches. These two steps are considered to be the two main preparation steps, where the release of adhesions to be able to allow the meniscus to be pulled back in the joint and also decortication of bone to prepare a bony bed to repair the meniscus back to the tibia. Great doctor. 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. 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. You can schedule an office consultation with Dr. LaPrade. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. 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. For this reason, much research has gone in to meniscus root repairs over the last several years. My experience with Dr. Burnham and his staff was exceptional. <> Surgical repair can successfully allow the meniscus to heal. For these, please consult a doctor (virtually or in person). dressing in 48 hrs and may let them drive If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. Meniscus Surgery: What to Expect at Home - Alberta Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. It is our goal to provide the highest level of care and service to our patients. 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. When Is Driving Safe After Rotator Cuff Repair? . Often the best medicine to take is NSAIDs like naproxen and ibuprofen. 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. My calf swelled up into my ankles. I was going to rehab myself, and keep training as normally as I could. It was tough, and it hurt like hell, but I took it slowly. I am a coach, and I have two boys playing sports, the best thing I can say is that my sons will go see Dr. Burnham in the event they are injured, and I will always recommend him to my athletes. Medication may be needed for 2-3 weeks. I kept training, modifying my squatting as needed until I could get back to proper depth. He was outstanding. It was press/bench day, so I set up for some seated presses and dragged a stool over to prop my left leg up while I benched. Dr. Burnham made sure I knew what was happening and what could happen. Therefore, it is strongly recommended to proceed with a meniscus root repair whenever possible, with patients up to the age of 70 being reported as having excellent return of function. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. Their sense of compassion and understanding is more than we have ever experienced. They might have a follow up visit or two but its really physical therapy that suppose take over at that point in physical therapy just has you for two to three months and once theyre done with you same thing once youre back to walking and bending your knee all the way and straightening out your knee all the way. These are totally different. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. A meniscus can become damaged due to sudden trauma. Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. 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. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. And theres things that you can do, which Ill allude to here in the middle. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. This allows the meniscus to heal back to the bone. It helps to be strong, my PT remarked. A torn meniscus can result in either sudden or gradual onset of pain. 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 the early stages of your meniscus tear you can take these conservative and essential treatments which are as follows: Rest Ice every 15 minutes in every 4-6 hours Compression with an ACE wrap or sleeve Elevation of the leg Nonsteroidal anti-inflammatory medications (NSAIDs) for pain. This is because the signs of arthritis are usually pain and swelling with activities. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. How long did you have to avoid driving after meniscus surgery? I'm taking pain meds regularly to try and ease pain. Your subscription could not be saved. Post Operative Knee Arthroscopy FAQs - Complete Orthopedics Full recovery from meniscus surgery can take anywhere from six weeks to three months. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. The most important thing as one gets older is the quality of the cartilage present. 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. How long recovery takes depends on the type of meniscus surgery and the severity of the injury, but expect two weeks down time, at minimum. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time.