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. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. dressing in 48 hrs and may let them drive Dr. Burnham and his remarkable staff have been a godsend for our son. Browse archives. Sit at home on the couch and watch T.V.? My calf swelled up into my ankles. 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. Post Operative Knee Arthroscopy FAQs - Complete Orthopedics 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. Is this a tear? 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. The drill tip can then be pulled out, leaving the cannula in place, which allows one to place a passing stich up it to subsequently shuttle sutures down the tibial tunnel. How long do you have to avoid driving after meniscus tear surgery This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. In this technique, sutures are placed into the torn meniscus root and then shuttled down tunnels in the tibia to tie the repair into place. Meniscus Root Repair Northeast Philadelphia, PA | Meniscal Root Tears Weight bearing as tolerated after 6 weeks. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. How Soon Can I Return to Work After Meniscus Surgery? The healing phase is long, but he does A+ work. I left my visit feeling very comfortable with where I was and what needed to happen next. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. 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. Therefore, a lateral meniscus root repair can be an essential portion of a surgery to address the secondary restrains for a concurrent ACL reconstruction procedure. Dr. Burnham and Jerrica are AMAZING! Are you an athlete who participates in sports that involve running and jumping? Meniscal Root Repair Alone or Combined with Different Procedures After I have no issues taking the stairs, just a little knee discomfort here and there. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Torn Meniscus | Meniscus Tear Treatment Options | Duke Health 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 . Highlights from the StartingStrength Community. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. A meniscus that still has extrusion present also does not function as well over the long term. When I woke up I was in significant pain but the nurses had it under control by the time I left. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. His MA Michelle was very professional and kind. PDF Knee Arthroscopy Meniscus Root Surgery FAQ - Twin Cities Orthopedics Return to Sport after Meniscus Surgery Chicago, IL | Dr. Jorge Chahla According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. Regular assessment of gait to avoid compensatory patterns. I could no longer deadlift from the floor, and was having trouble squatting below parallel. We currently use UltraTape to do this. Dr. Burnham clearly cares about his patients and their follow up care. Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone). 3 0 obj One of the most common is in patients who may have some underlying arthritis and the arthritis is causing the pain or the arthritis has progressed further after the meniscus root repair. 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 Wednesday: 8:00 am 5:00 pm Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Is this normal? Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. 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. It was glorious. with time whether there is healing or not. It was press/bench day, so I set up for some seated presses and dragged a stool over to prop my left leg up while I benched. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. 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. I would highly recommend him. Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. In the early stages of your meniscus tear you can take these conservative and essential treatments which are as follows: Rest Ice every 15 minutes in every 4-6 hours Compression with an ACE wrap or sleeve Elevation of the leg Nonsteroidal anti-inflammatory medications (NSAIDs) for pain. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. Great shoulder doc. The most common complication after a meniscus root repair is a re-tear. 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. Meniscus Root Tear | Knee Doctor | Baton Rouge, LA - Jeremy Burnham, MD (B) Posterior root lesion of lateral meniscus. It is shaped like a C and it serves to cushion and stabilize the knee. Non-anatomic root repairs do not restore normal joint biomechanics . And they can get back to normal in about two or three months after having the surgery. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. My surgery was at 8:30am Wednesday, February 20. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. The meniscus is a cushion of the knee joint. He answered all of my concerns about my knee. Oct 24, 2020. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. The recovery time for meniscus surgery depends on the type of surgery you had. Previous attempts to make it better provided only temporary relief. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. 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. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Then, in January of 2018, while warming up in class one morning, a sharp, nauseating pain shot through my left knee, which made me start limping. 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. 2 0 obj Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. PDF Meniscal Root Repair Post-operative Orders If not even worse. But if we are stronger, we are harder to break, and we most certainly recover faster and better. 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. . 1) You must be off narcotic medications for a . (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. The protocol is divided into phases. Your knee will be swollen. <> 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. Takes his time with you and doesn't hurry to rush out of the room if you have questions. 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. Healing kind of goes fast the beginning and then it tapers off. I would recommend his service to any recreational athlete. The other aspect that needs to be evaluated is the amount of extrusion of the meniscus. Some patients may experience catching, clicking, or locking of their knee. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. This happens way more often than I like to admit. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! And its a lot slower for the remaining, you know, six to nine months after the first two or three months. The posterior roots are the most important as this is where a root tear occurs most commonly. He is walking without a limb and is on schedule with his progress. importance of the meniscus root has become more apparent. Can you tear your meniscus again after a surgery and if you do how can you tell? endobj 4010 W. 65th St. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. Surgical repair can successfully allow the meniscus to heal. Posterior Meniscal Root Repair Using a Meniscal Suture Device In recent years the importance of the meniscus root has become more apparent. Easy to talk to and will answer any questions of your care. PDF Knee meniscus root repair - tcomn.com It helps to be strong, my PT remarked. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. My repair will be later this week on my right leg. 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. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. They moved my knee a bit, and I had decent ROM, better than expected. The Steadman Clinic - Edwards, CO When I returned home around 1pm that day, I sat in my living room for a bit, emailing and texting people to let them know I was alive and well. Typically begins 3-5 days after surgery; Precautions Toe touch weight bearing with brace; Gradually unlock brace for 6 weeks; after 6 weeks no brace My 14 year old son originally went in to see Dr. Burnham very scared (he hadn't had an injury before) and he was instantly made to feel at ease. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 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. 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. A possible cause for knee pain 1 year after meniscus surgery would be a re-tear of the meniscus. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. 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. Instead of wall slides, I opted for high box squats. Meniscus root repair surgeon, Doctor Benedict Nwachukwu provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, New York City, NY who need meniscus root repair surgery. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. I'm able to run and exercise without pain. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. Partial weightbearing status (<50%), unless otherwise ordered by MD. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. And theres things that you can do, which Ill allude to here in the middle. 2018;47:762. This allows the meniscus to heal back to the bone. So the focus of physical therapy after a knee meniscus surgery is getting your motion all the way back and then getting strong enough to stand and do some walking. 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. Dr. Burnham was very thorough with his examination and diagnosis. After sutures are placed arthroscopically into the meniscal attachment, a small diameter tunnel, usually 5 millimeters in size, is reamed to the meniscal root attachment site, the sutures are pulled down the tunnel, and tied over a button on the anterior cortex of the tibia. 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. We are so grateful and thankful. The procedure can be a complete meniscectomy where the meniscus and the . What is the Recovery Time for Meniscus Tear Surgery? - SportsMD Procedure for Meniscus Root Repair. Meniscus Tears: Why You Should Not Let Them Go Untreated His surgery and recovery has been perfect! This allows the meniscus to heal back to the bone. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. Meniscus root tears - a devastating injury - Dr. Bu Balalla 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. 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. There was absolutely no knee pain. What to do if I have a radial meniscus tear, what's the chance of it fully healing with surgery? The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. But now I know more about the body, about rehab, and about what being stronger really means. Heel lift in opposite shoe to normalize gait. While there are a small number of patients who do have their meniscus root re-tear, this has been nowhere near as common as the other sources noted above. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. My wait time for office visits has always been less than 10 minutes. He answered all my questions satisfactorily and his entire staff were polite and professional. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Sometimes the meniscus damage occurs more gradually as part of degeneration. The most common method to fix meniscus root tears is through a tibial bone tunnel. You can't walk right after surgery. What Causes Knee Pain 1 Year After Meniscus Surgery? The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. I am now adding 10 pounds a week to the bar for squats. 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. I recommend him, as well as his staff, to anyone requiring such services. If you break down what most healthcare provision professionals tell their patients, it could be an orthopedic surgeon, or even a physical therapist, its telling somebody whos just had a meniscus surgery, theyll say, well, 80% of healing is done in the first two to three months. You may need to leave a message. Currently, there are mini First-Pass devices that curve to the right and the left, which allows increased access to a root tear, especially since most root tears tend to squirt to the back part of the joint and can be more difficult to access with a straight biter. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. 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. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. . The . The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. At the beginning of April, I was dancing at a friends wedding when I suddenly heard and felt a loud pop in my left knee. 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. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. Tuesday: 8:00 am 5:00 pm Now, the focus when you go into a surgeons office, theyre looking at your MRI, theyre looking at your meniscus on the MRI, theyre telling you the tear in the way that its torn and how theyre going to repair it. If one does have quite a bit of arthritis of the same compartment, which we would call Kellgren-Lawrence grades 3 or 4, in most circumstances, other than possibly in very young patients, a root repair would generally not be indicated. It was tough, and it hurt like hell, but I took it slowly. Really cares for his patients! Medication may be needed for 2-3 weeks. 1 0 obj Meniscal Repair. So happy I found them! The most common root repair technique is called a transtibial technique. The incisions leave scars that usually fade in time. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 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. 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. Country. Full recovery from meniscus surgery can take anywhere from six weeks to three months. Meniscus Injury - Sports Medicine Research - Mayo Clinic I think my clients thought I had lost my mind, but what else was I going to do? Most meniscus root tears require surgery. 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. 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. These are totally different. 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. Definitely recommend. 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. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). 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.