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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. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. I would recommend his services to anyone. Definitely a Bakers Cyst, my doctor said when I saw him. I chose not to use my crutches anymore. Highlights from the StartingStrength Community. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. 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. #JimmyWinkfield is 1 of 5 men to win the prestigious twitter.com/i/web/status/1, What are #loosebodies in the #hip? 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. Contact Dr. Nwachukwus team today! This is probably due to many factors, including the chronicity of the tear, the quality of the tissue, if the meniscus was released from scar tissue and pulled back in the joint, ones age, ones weight, and ones alignment. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. I was told it would be about 6 weeks, but my instructions are to wear a brace at full extension for the duration of this time. My experience with Dr. Burnham and his staff was exceptional. Two days after my surgery, Diego took me to my first PT session. Is this normal? % I consulted with SSC and DPT Darin Deaton prior to my surgery and then afterwards, when I discovered it had been a meniscus root repair. Other non-medical modalities may help, such as using ice and elevating the leg. Heel lift in opposite shoe to normalize gait. The most important thing as one gets older is the quality of the cartilage present. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. You'll likely regain your previous muscle strength in the leg by. importance of the meniscus root has become more apparent. But now I know more about the body, about rehab, and about what being stronger really means. Meniscus root repair surgery recovery Most patients can return to full activity 4-6 months after a meniscus root repair. And get the pain under control and recover normally the way that you should have once you start doing the right things. 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 would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. 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. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). Most of these types of injuries, that are symptomatic, require surgery. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. Meniscus root repair is a surgery performed to repair a torn meniscus root. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. 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. By far the best orthopedic team I have ever met. In our hands, because we have performed many second look arthroscopies, we have found that the 2-tunnel technique allows for a broader surface area of the meniscus against the decorticated bone and seems to allow for a more solid and secure repair. 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. Video chat with a U.S. board-certified doctor 24/7 in a minute. He provided a thorough explanation without wasting time. A Guide to Orthopedic Care, Pediatric & Adolescent Sports Medicine Injuries, Get the Perfect Grip on Your Next Game: Adaptive Golf Gloves, Healthcare Journal of Baton Rouge Mentions Dr. Burnham Performing New Surgery to Repair Torn ACL, Sports Medicine Near Me: Finding the Right Doctor for You, When to See a Doctor for Knee Pain When Bending: The Complete Guide, 11 Benefits of Exercise: It Can Change Your Life, Knee Bursitis: Causes, Symptoms, and Treatment Options, Your Childs Knocked Knees: Everything You Need to Know, BioUni OATS Procedure Cartilage Replacement for the Knee, Capsulorraphy Shoulder Stabilization Procedure. Im telling you right now its going to take six to 12 months just erase that number that they gave you in your head and i wouldnt go argue with them because they may not have all the knowledge and understanding behind it and truth be told surgeons oftentimes you know once they finish their surgery theyre kind of done with you. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. Usually, pain is minimal after this type of surgery. Progression of range of motion is more limited than for a standard meniscus root repair, usually limiting patients to 0-60 or 0-90 degrees range of motion for the first 4 weeks and then slowly increasing range of motion as tolerated. endobj Request Case Review or Office Consultation, Lateral Patellotibial Ligament Reconstruction, Anatomic Analysis of the Posterior Root Attachments of the Menisci, Posterior Root Avulsion Fracture of the Medial Meniscus, Not Your Fathers (or Mothers) Meniscus Surgery, Anterior Intermeniscal Ligament of the Knee An Anatomical Study, Popliteomeniscal Fascial Tears Causing Symptomatic Lateral Compartment Knee Pain, Prospective Outcomes Study of Meniscal Allograft Transplantation. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. 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. 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. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. 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. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. Very reassuring, showed me X-rays and explained the healing process very clearly. with time whether there is healing or not. 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. 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. Two important criteria exist to begin driving after meniscus surgery. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. Procedure for Meniscus Root Repair. And Im a specialist physical therapist El Paso manual physical therapy. Dr. Burnham was very helpful for my injury! Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? There goes my knee again.. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. We recognized that meniscus root tears were a problem over 10 years ago and set out to perform a comprehensive research program to help us figure out how to diagnose the problem, where to place the meniscus repair, and how best to fix the meniscus tear to allow for maximal healing capability. There are 2 main variants of the transtibial root repair technique. Do minor meniscus tears require surgery or can it repair itself? 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. I got rid of the box for squats the end of July. What do you suggest if my MRI says that I have a horizontal tear in the body of the lateral meniscus is shown do I need surgery? It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. 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. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. Please try again. Most root tears involve either a direct tear of the meniscus off bone or a split of the meniscus within 1 cm of the root attachment. Dr Burnham is so personable. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. This results in premature arthritis and cartilage damage in the knee. This is because the signs of arthritis are usually pain and swelling with activities. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. 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. Dr. Burnham is amazing. And they can get back to normal in about two or three months after having the surgery. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. 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. Great shoulder doc. He answered all my questions satisfactorily and his entire staff were polite and professional. Many tears have better outcomes if they are treated early. 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. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 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. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. Robert LaPrade, MD, PhD The knee will be swollen for 2-3 months. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. 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. I'm able to run and exercise without pain. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. So happy I found them! 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. This answers all my questions! Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. 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. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? They can occur in younger patients as a result of high energy trauma, but are more common in patients between 45 and 60 as a result of degeneration of the meniscus with age. Surgical repair can successfully allow the meniscus to heal. 4. So if thats your feeling youve taken them and it hasnt really made a difference for you dont take them if you feel like to help you out please take them but dont just take the supplements in hopes of that replacing doing the right exercises and having the right expectations youve got to do them both together give us a like if you thought this video was helpful and please drop a comment if you have any questions and i hope that you get better real soon have a wonderful day guys. Most patients will also have some numbness around the surgical incision, but this is not a true complication and is anticipated with any type of surgical incision. amount of, supply and beyond the age of 15 has limited healing without surgery. 181 West Meadow Drive Suite 400 Vail, CO 81657. General anesthesia and a nerve block. The other aspect that needs to be evaluated is the amount of extrusion of the meniscus. If you had a knee surgery if youve been seen physical therapy or any other health care professionals and theyre telling you youll be fine in three months back to normal youll be dancing youll be exercising youll be playing with the grandkids again just smile and remember this video. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. 1 0 obj This hoop stress is resisted by fibers that run circumferentially through the meniscus. And its really concerning and very disappointing for somebody whos gone through the knee surgery. Stated to me , in detail, what to expect and how long my recovery will take. He was outstanding. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. Does having a cortisone shot help a meniscus tear or is surgery the only option? 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. The most common complication after a meniscus root repair is a re-tear. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. My daughter journey was very trying and hard but we made it through with all of their help. I recommend him, as well as his staff, to anyone requiring such services. 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. I can run, bike, & climb mountains. 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. Patients are allowed to walk 4-6 weeks after surgery. Timeline for Meniscus Repair Recovery: It will take around 4-6 weeks before you can walk, drive, and otherwise move normally as you would prior to your injury. 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 addition, if the medial meniscus is involved, active 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. Often, when a meniscus root is torn, it will retract in the joint and become stuck in place. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. 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. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. Most meniscus root tears require surgery. He answered all of my concerns about my knee. It is vital that meniscus repair patients do not squat for at least four months after the repair. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. I highly recommend him. Thanks to Dr. Burnham and his staff. 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. Definitely recommend. And then they lose motion. Two weeks to the day, I got on my spin bike at the gym and did what I could do. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Specializes in Orthopedic Reconstructive Surgery. 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. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. I got a lift home, and returned to the gym later that evening for more coaching. 2018;47:762. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Super knowledgeable. I am so glad I did! 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. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. The feeling that your knee is giving way, locking, or catching when you bend it. The meniscus is a piece of cartilage in the knee, often injured in sports. . Therefore, we found that non-anatomic meniscus root tear repairs were not successful. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. I walked around the gym with the crutches, and without the crutches. The meniscus is a very important piece of cartilage in the knee. 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. 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. 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. 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. Proper fixation of the meniscal root can prevent or slow down the development of arthritis in that area of the knee. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. short distances based on their motion and 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. Very positive experience at Bone and Joint Clinic in Baton Rouge. What made my recovery so fast? If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . In fact 2 years ago I finished climbing the top 100 peaks in CO. The study included 351 patients with knee OA and meniscus tear. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. We had a wonderful experience and I highly recommend him. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. 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. 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. He will now be caring for my hip and knee in the future. 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. Meniscus repair is usually done with arthroscopic surgery. <> Timeline: 1 week to 5 weeks after Surgery. Strength is one of the most important aspects of our lives. Meniscus repair rehab protocol. I was very pleased seeing Dr. Burnham, however I was not pleased to learn I was expected to pay an additional co- pay within the same week to receive the results of my MRI. Definition/Description. I wont ever go anywhere else. But youve got to figure out a way to get your butt muscles stronger if youre looking for a more comprehensive plan for making your knee better and getting your glutes stronger we also have a program called the, https://www.epmanualphysicaltherapy.com/wp-content/uploads/2020/01/Logo-copy-1030x429.jpg, Shoulder Impingement: Everything You Need To Know To Get Healthy Again, Top 5 Shoulder Impingement Exercises To Help Get Healthy Again, Top 6 At Home Treatments To Begin To Naturally Heal Cervical Radiculopathy, Click Here To Schedule A Phone Call With An Expert, Click Here To Ask About Cost & Availability, Copyright 2022 - El Paso Manual Physical Therapy, How To Tell If Youve Got A Rotator Cuff Tear, Request A Virtual Visit With One Of Our Expert PTs, 28 day knee health and wellness boost program, 28-Day Knee Health & Wellness Boost Program, 28 Day Back Health & Wellness Boost Program. And now theyre kind of back to the way they were before the surgery. I'm taking pain meds regularly to try and ease pain. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! And I feel my rode to recovery will be wonderful. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. He has repaired both of my shoulders and he is awesome to the max. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. Therefore, our surgical technique, using specific guides to avoid the eminences to ensure that one can place the guide exactly where one wants to have a cannula come out in the joint, using cannulas to allow for placement of passing sutures quickly and efficiently, having 2 separate cannulas with 2 separate tunnels for the meniscus repair, releasing the meniscus thoroughly to pull it back in the joint so it functions most effectively, and then having self-capture suture devices, which can place suture or tape into the meniscus substance, shuttle them down the tibia, and then tie them over a metal button on the tibia. Dr. Burnham and his staff were/are amazing. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). Edina, MN 55435, EAGAN-VIKING LAKES OFFICE drive the next day if they feel ok. Also, I had to make numerous visits to the Ochsner Clinic due to my injury and Dr. Burnham's team and the staff at Ochsner were always very professional and courteous. Dr. Burnham performed my hip pin surgery and it all went extremely well. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. And thats all good if youre going to end up having the surgery. The meniscus root is where the meniscus attaches to bone. But typically physical therapy goes two to three months you get 80% better and a lot of times people have the expectation setting themselves that they can get back to everything that theyre doing before and thats just not the case they can do a lot of things now that they couldnt before the surgery typically. The length of time until patients are able to return to driving varies . Many patients do not have significant joint line pain like a typical meniscus tear, so having a patient stand up and squat down is often performed during the clinical exam to validate that the patient may have a meniscus root tear. We are so grateful for you both! Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg.