However, if the meniscus re-tore or is placed into a non-anatomic position and ones cartilage surfaces are still fairly intact, an attempt at a revision repair should be made. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 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. Most meniscus root tears require surgery. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. 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. It takes longer for a meniscus repair to heal than a meniscectomy. You'll begin a graduated rehabilitation protocol. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. We love you! This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. 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. It is shaped like a C and it serves to cushion and stabilize the knee. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone). HSS Sports Medicine Institute West Side Two weeks to the day, I got on my spin bike at the gym and did what I could do. Monday: 8:00 am 5:00 pm Dr. Burnham was very personable and explained my situation in great detail. Thank you for choosing Dr. LaPrade as your healthcare provider. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. I could no longer deadlift from the floor, and was having trouble squatting below parallel. 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. Most patients with meniscal root tears will ultimately need surgical fixation of the root. I can run, bike, & climb mountains. Each horn is anchored to the bone at the meniscus root (anterior and posterior). 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. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. Ill def refer friends and family! 2700 Vikings Circle The most important aspect to assess when one is looking at a root repair is to ensure that ones cartilage surfaces are still fairly normal. 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. For these, please consult a doctor (virtually or in person). 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. Many tears have better outcomes if they are treated early. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. And I feel my rode to recovery will be wonderful. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. This may be recommended depending on the type of meniscus tear. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. I really like and appreciate the time and effort he commits to research. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. 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. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. I continued to lower the box for squats, and started to add weight. 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. He has repaired both of my shoulders and he is awesome to the max. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. 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. 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. Does having a cortisone shot help a meniscus tear or is surgery the only option? 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. Thank you Dr. Burnham and Jerrica for everything! 2 0 obj Begin passive range of motion exercises Start physical therapy or home exercise program 1-3 days after surgery Work on quad recruitment Brace/Crutch Use 25% weight bearing with crutches, brace 0-90 when ambulating and sleeping, can remove . 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. I left my visit feeling very comfortable with where I was and what needed to happen next. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. 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. Healing kind of goes fast the beginning and then it tapers off. Diego has an automatic and it was my left knee that was incapaciated, not my right, so the next day, I hobbled into his car and practiced driving around the block. How long after surgery for a meniscus tear will i be able to drive again. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the 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. Knows his stuff. #JimmyWinkfield is 1 of 5 men to win the prestigious twitter.com/i/web/status/1, What are #loosebodies in the #hip? Takes his time with you and doesn't hurry to rush out of the room if you have questions. I highly recommend Dr Burnham for your orthopedic needs hands down. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. 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. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. Specializes in Orthopedic Reconstructive Surgery. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. These are totally different. Call your doctor or 911 if you think you may have a medical emergency. 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. Then I trained. 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. 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. I would highly recommend him. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. Definition/Description. Dr. Burnham and his staff were/are amazing. Full recovery usually takes 6 months but can take up to 1 year. And if youve already had your meniscus surgery, then you know what to do so that youre not getting more swelling, pain and not losing motion than that knee and youre staying out of the surgeons office, so you dont have to go back again for another knee surgery. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. 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 28 day knee health and wellness boost program you can also find that in the link and as a link in the description below. Few tears will become. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. 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. 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. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. His extensive schooling, research, and commitment to his craft shined through at every turn as he evaluated my injury, presented all my options (clearly explaining non-surgical options and expected outcomes), and helped me plan my course of treatment and recovery. Very professional! An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. Patients are allowed to walk 4-6 weeks after surgery. His team is prompt, thorough, and fun - always smiles. 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. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. So happy I found them! Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. Meniscal Repair. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. 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. 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. Thanks to his staff for being so helpful. Very positive experience at Bone and Joint Clinic in Baton Rouge. 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. Rehabilitation begins within a week of surgery. Can you tear your meniscus again after a surgery and if you do how can you tell? 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. We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. 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. He has a great rapport with teenagers. I highly recommend him. Dr. Burnham made sure I knew what was happening and what could happen. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. Meniscus repair is usually done with arthroscopic surgery. Walk with crutches. Well, this is not normal. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. Instead of wall slides, I opted for high box squats. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. The following Tuesday, I saw my doctor. It was tough, and it hurt like hell, but I took it slowly. 28323545 Additionally, preparing 2 transtibial tunnels to secure the meniscal root to its attachment site further increases the In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. I am now adding 10 pounds a week to the bar for squats. 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. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. A written consent will be obtained from you after the surgical procedure has been explained in detail. Two weeks. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. Dr. Burnham and his remarkable staff have been a godsend for our son. 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. And if we know anything about cartilage, if you want to look this up, it takes about six up to 12 months to fully heal depending on the severity of that injury on the meniscus on that cartilage. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. If the surgery is on the right leg i change to If so, you may be at risk of tearing the root of your meniscus. 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. Oftentimes healthcare providers will tell you go walk your knees operated on its good youre the we took out the chunk that was you know causing your need to lock up the meniscus we did a meniscectomy or we repaired the meniscus and its all sewn together now so you can go ahead and walk all you want and some people take that to heart and to go walk you know three miles a day or even 10-20 miles a week and their meniscus just doesnt heal enough and they get that swelling. I definitely know that I would not have been able to do all that I can do now, if I had not gone into the surgery strong. repair to heal. You have two roots per meniscus which include anterior and posterior roots. 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. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. Thanks to Dr. Burnham and his staff. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. It is our goal to provide the highest level of care and service to our patients. The meniscus root is where the meniscus attaches to bone. And they can get back to normal in about two or three months after having the surgery. Partial weightbearing status (<50%), unless otherwise ordered by MD. 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. My name is Dr. David Middaugh. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. (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. And they can get back to normal in about two or three months after having the surgery. %PDF-1.5 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. 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? A meniscus root tear usually will not heal on its own. Recommend highly. And its really concerning and very disappointing for somebody whos gone through the knee surgery. And thats all good if youre going to end up having the surgery. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. <>/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>> But now I know more about the body, about rehab, and about what being stronger really means. You'll likely regain your previous muscle strength in the leg by. It can create another problem later on youve got to listen to your knee youve got to listen to your body and make sure that you only go with what you can tolerate without making it worse without swelling pain or definitely not losing motion and you might consider staying in physical therapy longer than they want you to or finding something to help you out. 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 goal of a meniscus root tear repair is to locate the torn root and tack it back down to the bone using strong sutures. This is done to protect the repair and let the body heal it. The pain during my recovery has actually only been minimal, requiring no pain meds. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. Other sources of pain can include scarring within the joint that occurs as a normal part of a surgical procedure, or pain from other pathology and joint, such as arthritis under the kneecap. Strength. He and his staff could not have been more helpful and professional. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. EDINA- CROSSTOWN OFFICE I have successfully repaired meniscus root tears in patients that were 70 and 71 years old respectively and they are some of my happiest patients. When I said I was not on any medication, he said when I could bend my leg 90 degrees. 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. No swelling. Meniscus root repair is a surgery performed to repair a torn meniscus root. They explain things very well. 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. Appreciate the attention and time spent during office visits. while avoiding unnecessary surgery, injections, and medications. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? 3 0 obj (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. 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. while avoiding unnecessary surgery, injections, and medications. 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.