Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. I wasnt taking any pain medication either, so I was alert. And now theyre kind of back to the way they were before the surgery. 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 . A written consent will be obtained from you after the surgical procedure has been explained in detail. Many tears have better outcomes if they are treated early. 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. 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. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. A meniscus root tear occurs when one or both of these roots tear away from the bone. After about five minutes, the wheels were spinning. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. When I went in arthroscopically and thoroughly released the meniscus, pulling it back into an anatomic position and revising the repair; all of these patients seemed to have much improved pain relief. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. His MA Michelle was very professional and kind. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. An ACL tear commonly has a pop on the outside of the knee, whereas a patient who has meniscus root tear commonly feels a pop in the back of the knee. with time whether there is healing or not. He diagnosed the problem quickly and accurately. 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. He will now be caring for my hip and knee in the future. The . He listens and address every concern with appropriate solutions. 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. I am now adding 10 pounds a week to the bar for squats. I finally decided to make an appointment with a knee specialist. If patients put weight on the knee immediately after the repair, the forces on . You have two roots per meniscus which include anterior and posterior roots. It can be very difficult to interpret an MRI after a meniscus root repair. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. 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. 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. But if we are stronger, we are harder to break, and we most certainly recover faster and better. 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. And they can get back to normal in about two or three months after having the surgery. I'm able to run and exercise without pain. Because this is a frequent question posed on Google, I will try to be modest in answering this. There can be many factors which can potentially cause pain after a meniscus root repair. 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. 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. But youre also not alone. I felt very informed and well cared for. I think my clients thought I had lost my mind, but what else was I going to do? 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. 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. 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. Meniscus root repair is a surgery performed to repair a torn meniscus root. We had a wonderful experience and I highly recommend him. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. Appreciate the attention and time spent during office visits. 5 stars! 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. And cartilage is one of the slowest healing tissues in the body. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. Thank you for choosing Dr. LaPrade as your healthcare provider. <> Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. The American Journal of Sports Medicine. endobj And I feel my rode to recovery will be wonderful. After hours 763-520-7870 Address Maple Grove 9630 Grove Circle N., Suite 200 Maple Grove, MN 55369 Minnetonka 15450 Highway 7, Suite 100 Minnetonka, MN 55345 Robbinsdale 3366 Oakdale Ave. N Suite 103 Robbinsdale, MN 55422 Knee Meniscus Root . Next, we performed biomechanical studies to show the effects of varying sizes of radial meniscus root tears, validating that a meniscus root tear within a centimeter of its attachment site functions as a meniscus root tear and can be treated the same. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. This is one of the first video demonstrations of this. Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. 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. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. 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. 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. You will feel tired for several days. 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. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. Great doctor. This can occur in up to 20% of patients, even in the best of circumstances. 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. 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. In general, patients have to develop good quadriceps strength to allow for maximum absorption with activities prior to returning back to any significant hiking, jogging or running activities. 2 0 obj 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. Then I trained. And Im a specialist physical therapist El Paso manual physical therapy. The torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. endobj Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients This hoop stress is resisted by fibers that run circumferentially through the meniscus. - Privacy Policy - Louisiana Retina, Dr. Jeremy Burnham, MD - Sports Medicine, Orthopedic Surgeon, Knee Doctor, Jeremy Burnham, MD - Sports Medicine & Orthopedic Surgeon, __CONFIG_colors_palette__{"active_palette":0,"config":{"colors":{"f3080":{"name":"Main Accent","parent":-1},"f2bba":{"name":"Main Light 10","parent":"f3080"},"trewq":{"name":"Main Light 30","parent":"f3080"},"poiuy":{"name":"Main Light 80","parent":"f3080"},"f83d7":{"name":"Main Light 80","parent":"f3080"},"frty6":{"name":"Main Light 45","parent":"f3080"},"flktr":{"name":"Main Light 80","parent":"f3080"}},"gradients":[]},"palettes":[{"name":"Default","value":{"colors":{"f3080":{"val":"rgb(23, 23, 22)"},"f2bba":{"val":"rgba(22, 23, 22, 0.5)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"trewq":{"val":"rgba(22, 23, 22, 0.7)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"poiuy":{"val":"rgba(22, 23, 22, 0.35)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"f83d7":{"val":"rgba(22, 23, 22, 0.4)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"frty6":{"val":"rgba(22, 23, 22, 0.2)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"flktr":{"val":"rgba(22, 23, 22, 0.8)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}}},"gradients":[]},"original":{"colors":{"f3080":{"val":"rgb(23, 23, 22)","hsl":{"h":60,"s":0.02,"l":0.09}},"f2bba":{"val":"rgba(23, 23, 22, 0.5)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.5}},"trewq":{"val":"rgba(23, 23, 22, 0.7)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.7}},"poiuy":{"val":"rgba(23, 23, 22, 0.35)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.35}},"f83d7":{"val":"rgba(23, 23, 22, 0.4)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.4}},"frty6":{"val":"rgba(23, 23, 22, 0.2)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.2}},"flktr":{"val":"rgba(23, 23, 22, 0.8)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.8}}},"gradients":[]}}]}__CONFIG_colors_palette__, Cartilage Damage: Symptoms, Causes, & Treatment, Elbow Rehabilitation and Postoperative Protocols. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. My wait time for office visits has always been less than 10 minutes. They walked me through the process from beginning to end. These UltraTape or sutures can then ultimately be shuttled down the cannulas and then tied over a metal button on the front part of the tibia. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. 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. But its just not common knowledge to take six to 12 months to heal after a meniscus surgery. Procedure for Meniscus Root Repair. 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. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. 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. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. 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. You'll likely regain your previous muscle strength in the leg by. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? I am so glad I did! 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. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. I recommend him, as well as his staff, to anyone requiring such services. I have no issues taking the stairs, just a little knee discomfort here and there. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. I was going to rehab myself, and keep training as normally as I could. 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. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? 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. But now I know more about the body, about rehab, and about what being stronger really means. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. I limped from the wedding venue to the car, and then from the car to my house. Nothing. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . They are also important to the stability and function of the knee, keeping the meniscus in place. And then they lose motion. short distances based on their motion and Patients often report hearing a pop at the time of injury. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. The transtibial meniscal root repair is emerging as the gold standard treatment due to its ability to restore a large footprint at the meniscal root's native attachment site and restore normal joint contact pressures. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. 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. 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. 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. Very reassuring, showed me X-rays and explained the healing process very clearly. 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 Never disregard or delay professional medical advice in person because of anything on HealthTap. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). 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. We currently use UltraTape to do this. In particular, making sure the meniscus has a thorough release from scar tissue and making sure that ones sutures or UltraTape are placed into the best substance possible for the meniscus root repair, are important considerations to maximize the chance of healing of the revision root repair procedure. This is important because these repairs are still quite tenuous with current technology, so it is important to try to put the meniscus back into a position where there would not be a lot of tension on the repair with knee range of motion. This happens way more often than I like to admit. Does a extruded medial meniscus towards the posterior root need surgery? Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. This is because the signs of arthritis are usually pain and swelling with activities. 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. Walk with crutches. The posterior roots are the most important as this is where a root tear occurs most commonly. You may need surgery to restore full knee function. Dr Jeremy Burnham has a great way of interacting with his patients. 1 doctor answer 2 doctors weighed in Dr. Jeffrey Sider answered Sports Medicine 41 years experience Depends: If surgery is on the left leg i let some patients drive the next day if they feel ok. Meniscal Ramp Lesions. I'm taking pain meds regularly to try and ease pain. There was absolutely no knee pain. The meniscus is a piece of cartilage in the knee, often injured in sports. Repair of the meniscal root significantly increased functional outcomes scores in 14 of 14 studies and the rate of conversion to TKA was considerably less than those observed following conservative treatment or partial meniscectomy. Is this a tear? Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. It hurt like hell. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. As of August 20, 2019, it will be six months post-op. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. In addition, there is no low age for meniscus repairs, with some root repairs being done in patients as young as 6 or 7 years old. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. importance of the meniscus root has become more apparent. Two weeks to the day, I got on my spin bike at the gym and did what I could do. Timeline: 1 week to 5 weeks after Surgery. Of patients treated with medial meniscal posterior root repair, 62.43% demonstrated complete healing on follow-up magnetic resonance imaging (MRI) or second-look arthroscopy. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. A meniscus root tear requires the meniscus to be repaired back to the lower leg bone; this is also performed arthroscopically. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Country. 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. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. A surgical guide can then be placed in a drill tip where the cannula around it is placed into the area of the decorticated bone. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. In cases the patients undergo meniscus repair or ligament reconstruction, they are given a brace to support the knee in full extension. No swelling. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. In addition, if the medial meniscus is involved, active 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. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. 515 Ray C. Hunt Drive, Suite 1100, Charlottesville, VA 22903 Phone: 434-243-7778 Fax: 434-243-5075 Meniscal Root Repair Post-operative Rehabilitation Protocol. The Steadman Clinic - Edwards, CO He has repaired both of my shoulders and he is awesome to the max. <>/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>> 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. 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. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. Previous attempts to make it better provided only temporary relief. We will determine during your consultation whether general or regional anesthesia would be appropriate - either way, no pain will be experienced during the procedure itself. Dr. Burnham was very thorough with his examination and diagnosis. He was outstanding. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. (it is still a bit swollen). After creating two transtibial tunnels, passing sutures through the detached root of the meniscus and down the tibial tunnels, the sutures are tensioned to reduce the root of the meniscus to anatomic position. Recommend highly. Their sense of compassion and understanding is more than we have ever experienced. What was going to help my knee? Most patients with meniscal root tears will ultimately need surgical fixation of the root. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. I never met a doctor and his team that showed some much compassion about their patient. With an injury like this you want the best, and Dr. Burnham is the best.