The average pain levels after a meniscus root repair fit between a basic knee arthroscopy (minimal pain) and an ACL reconstruction (more severe pain). Dr. Benedict Nwachukwu, orthopedic knee surgeon has extensive experience in treating meniscus root tears and can help patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. His surgery and recovery has been perfect! Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. I press and bench with no modifications. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. That night, I drove myself to the gym. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. It has now been demonstrated that the results of meniscectomies are almost the same as not treating the meniscus root tear at all with a large number of patients within 5 years proceeding to needing a total knee arthroplasty. Fortunately, this is usually done arthroscopically and with good results. Non-anatomic root repairs do not restore normal joint biomechanics . And the good news is that it can be helped without another surgery. Your care after surgery may involve: Crutches to take stress off the knee as it heals. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Dr. Burnham was very thorough and took the time to explain what he thought my root problem may be, why, and how he suggested we proceed with my care. MRI is used to look more closely at the meniscus and determine if it is something that needs surgical treatment, although not all meniscus root tears show up on MRI. I think my clients thought I had lost my mind, but what else was I going to do? 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. I really like and appreciate the time and effort he commits to research. Doctors typically provide answers within 24 hours. Browse archives. And if youve never worked out your glutes if you went through physical therapy never really targeted your glutes ever you better start quick because chances are youve got a muscle imbalance thats caused extra pressures inside your knee thats led to that meniscus tear to begin with thats been the root problem and glute strength is what offsets that forces inside the knee so that your meniscus can heal all the way. 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. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Meniscus Root Repair Rexburg ID | Meniscal Root Tears Rexburg ID PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. PDF Meniscal Root Repair Post-operative Rehabilitation Protocol Partial weightbearing status (<50%), unless otherwise ordered by MD. So getting swelling, or if its been a year since you had your meniscus surgery, and youre better overall, but youre still getting some swelling and pain, then its normal. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. Both my children have seen Dr. Burnham with great results. So lets get to it. 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. General anesthesia and a nerve block. This technique is fast and effective. Highly recommended! I was hit by a car on my bicycle near Horsetooth Reservoir in CO. The knee will be swollen for 2-3 months. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. While there are many factors that can go into extrusion, a maximum attempt should be made by the surgeon to try to pull the meniscus back in the joint to give the meniscus the best chance to function as a shock absorber after it heals. For this reason, much research has gone in to meniscus root repairs over the last several years. The meniscus is a cushion of the knee joint. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. 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. 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. The torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. 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. Robert LaPrade, MD, PhD 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. He will now be caring for my hip and knee in the future. Most patients with meniscal root tears will ultimately need surgical fixation of the root. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. Meniscus Post Surgery Rehabilitation Sutures are passed through the meniscus, and then pulled down into a bone tunnel located at the same site as the root attachment before it tore. Very professional! Meniscus Repair System Market Size to Reach USD 822.3 Meniscus Injury - Sports Medicine Research - Mayo Clinic Meniscal Root Tears - Dr. Chris Jones Colorado Springs, CO Great doctor. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. Healing kind of goes fast the beginning and then it tapers off. And cartilage is one of the slowest healing tissues in the body. But youre also not alone. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. If you're an athlete needing a doctor that understands; this is the guy. Country. I kept training, modifying my squatting as needed until I could get back to proper depth. I would recommend his service to any recreational athlete. I asked when I could start driving, and he said when I was off my pain medication. Each horn is anchored to the bone at the meniscus root (anterior and posterior). 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. 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. Two weeks today I had meniscus root repair. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. Most of these types of injuries, that are symptomatic, require surgery. I went to Dr. Burnham for issues I was having with my shoulders. The RICE (rest, ice, compression, elevation) principle can be useful in the first several days after a meniscus tear to help reduce inflammation, swelling, and pain. 4. The most common method to fix meniscus root tears is through a tibial bone tunnel. Posterior Meniscal Root Repair Using a Meniscal Suture Device Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. 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. Very thorough, knowledgeable and courteous. 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. (B) Posterior root lesion of lateral meniscus. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. 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. My pain was gone. 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. Patients often report hearing a pop at the time of injury. The goal of a meniscus root tear repair is to locate the torn root and tack it back down to the bone using strong sutures. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. I continued to lower the box for squats, and started to add weight. I also started boxing sessions once a week with one of my coaches as I am not allowed to start back to BJJ until September. Meniscus root repair is a surgery performed to repair a torn meniscus root. 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. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. I have now biked five to six days each week since my surgery. We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. Super knowledgeable. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Tuesday: 8:00 am 5:00 pm Rehabilitation Guidelines for Meniscal Repair of Root and Complex Tears So happy I found them! 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. 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. Never disregard or delay professional medical advice in person because of anything on HealthTap. How Long After Meniscus Repair Can I Walk? - Dr. Ramakant Kumar Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? Strength. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. And slowly, I started bending the knee more, and eventually took the box away from my bench. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. 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. 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. I highly recommend Dr Burnham for your orthopedic needs hands down. Recommend highly. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. Knows his stuff. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. You can schedule an office consultation with Dr. LaPrade. Specializes in Orthopedic Reconstructive Surgery. Many patients who do have a meniscus root tear note that they feel a pop in the back of the knee when they are doing squatting activities, such as cleaning floors, gardening, placing down carpet or plumbing. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. This happens way more often than I like to admit. Question: Can You Bend Your Knee After Meniscus Repair The swelling started to go down, but there was now a lump behind my knee that felt like fluid. One should not look at age as a factor for meniscus root repairs. His staff is very friendly and upbeat, knowledgeable and thorough. 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. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). 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. So if youre sitting at home right now, and you just had your meniscus surgery a month or two ago, and youre thinking, gosh, why arent I much better already. Meniscal Root Repair Alone or Combined with Different Procedures After Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . <>
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. The Steadman Clinic - Edwards, CO 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. 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. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. So that means youre good to go after two to three months. Meniscus Root Repair | Orthopedic Knee Surgeon | Vail, Aspen, Denver 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. What made my recovery so fast? Thank you Dr. Burnham and Jerrica for everything! In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. He is walking without a limb and is on schedule with his progress. To accomplish this goal, Dr. Nwachukwu drills a small hole from the outside of the tibia (shin bone) into the knee joint next to the natural attachment of the meniscus root. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE This is because the signs of arthritis are usually pain and swelling with activities. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. This results in premature arthritis and cartilage damage in the knee. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. #12. What is the Recovery Time for Meniscus Tear Surgery? - SportsMD That was day one. Meniscal root repair whether isolated or in combination with valgus HTO or ACL reconstruction, when indicated, was able to improve the clinical, functional and subjective results of the patients presented in this case series. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. 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. Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. It is shaped like a C and it serves to cushion and stabilize the knee. The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. Thanks to Dr. Burnham and his staff. Hence, that remaining meniscus is more and not less likely to tear again. Rehabilitation begins within a week of surgery. This hoop stress is resisted by fibers that run circumferentially through the meniscus. Meniscus tears & repairs - Overview - Mayo Clinic Orthopedics & Sports Dr. Burnham and Jerrica are AMAZING! With an injury like this you want the best, and Dr. Burnham is the best. When a torn fragment is floating in the joint, patients will feel a sudden, sha twitter.com/i/web/status/1, According to an injury study done in 2021, #Pickleball has been deemed safer than #tennis and better for individual twitter.com/i/web/status/1, Cysts Acetabular Paralabral and Subchondral, ACL Anterior Cruciate Ligament Injury of the Knee, Patellofemoral Pain Syndrome Runners Knee, PVNS of the Knee Pigmented Villonodular Synovitis, Osteochondral Allograft Transplantation Surgery (OATS), Patellofemoral Arthroscopy Runners Knee Treatment, Stabilization for Instability-Arthroscopic, Subacromial Decompression for Impingement, How to prevent common skiing and snowboarding injuries | Ski Injury Doctor Manhattan, BICMD Co-Founder and Co-CEO Announces Expansion of Services, Patients are partial weight bearing for the first 4 weeks and then during weeks 4-6 are progressed to full weight-bearing. while avoiding unnecessary surgery, injections, and medications. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Patients are allowed to initiate weightbearing at 6 weeks, but should avoid any significant squatting, squatting and lifting, or sitting cross-legged for a minimum of 5-6 months. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. Treatment Outcomes of Meniscal Root Tears: A Systematic Review Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? After Meniscus Surgery: What To Expect In The First Few Days And Weeks They are also important to the stability and function of the knee, keeping the meniscus in place. If the surgery is on the right leg i change to
amount of, supply and beyond the age of 15 has limited healing without surgery. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . Patient Testimonials - Meniscus Root Repair Everett | OCD Repair of the Knee Kirkland X Accessibility View Book An Appointment (206) 784-8833 Wallingford Office (206) 633-8100 Ballard Office (206) 784-8833 Home My Practice Practice Expertise Patient / Medical Resources Educational Resources Videos Radio/podcasts News Contact Dr. Garcia Facebook When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the He is on the cutting edge of research and techniques around surgery, he has a memorably reassuring bedside manner, and Im thankful he was in charge of my evalution and treatment. Sit at home on the couch and watch T.V.? After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. My repair will be later this week on my right leg. I wont ever go anywhere else. 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. Dr. Burnham made sure I knew what was happening and what could happen. The . No swelling. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. His MA Michelle was very professional and kind. Meniscus root repair | Knee Problems | Forums | Patient This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. 2018;47:762. #JimmyWinkfield is 1 of 5 men to win the prestigious twitter.com/i/web/status/1, What are #loosebodies in the #hip? 5 stars! Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. 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. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. with time whether there is healing or not. drive the next day if they feel ok. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Is this a tear? 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. The best surgeon is Baton Rouge that actually care about his patients!!! I rate him 5stars. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. 181 West Meadow Drive Suite 400 Vail, CO 81657. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. I started Brazilian Jiu-Jitsu about four years ago. Meniscus Root Tear | Orthopedic Knee Specialist | Vail, Aspen, Denver It has been found that one suture alone for the repair does not work well, so a minimum of 2 sutures is required to maximize meniscal healing. They walked me through the process from beginning to end. 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. Other complications can include a blood clot, which is usually treated preemptively with some type of blood thinner, and irritation around the surgical button and/or surgical knot from the meniscus root tear. Meniscus Root Repair Northeast Philadelphia, PA | Meniscal Root Tears My surgery was at 8:30am Wednesday, February 20. The procedure can be a complete meniscectomy where the meniscus and the . The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. Previous attempts to make it better provided only temporary relief. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Surgical repair can successfully allow the meniscus to heal. This answers all my questions! Swelling and stiffness. I would like to thank Dr. Jeremy Burnham for his wonderful work and surgery on my left shoulder. In addition, if the medial meniscus is involved, active Ibuprofen (Advil, Motrin) Naproxen (Aleve) Dr Burnhams bedside manner was exceptional. Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery.