A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. Meniscus repair rehab protocol. The blood supply to the meniscus in an adolescent or adult is very poor. I walked around the gym with the crutches, and without the crutches. 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. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients Medication may be needed for 2-3 weeks. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. How Long On Crutches After Meniscus Repair? Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. 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. A Guide to Orthopedic Care, Pediatric & Adolescent Sports Medicine Injuries, Get the Perfect Grip on Your Next Game: Adaptive Golf Gloves, Healthcare Journal of Baton Rouge Mentions Dr. Burnham Performing New Surgery to Repair Torn ACL, Sports Medicine Near Me: Finding the Right Doctor for You, When to See a Doctor for Knee Pain When Bending: The Complete Guide, 11 Benefits of Exercise: It Can Change Your Life, Knee Bursitis: Causes, Symptoms, and Treatment Options, Your Childs Knocked Knees: Everything You Need to Know, BioUni OATS Procedure Cartilage Replacement for the Knee, Capsulorraphy Shoulder Stabilization Procedure. After you have surgery to repair a meniscus tear, you may need to build up your strength in the muscles of your leg that support your knee. In terms of when, one should plan to perform a meniscus root repair as soon as it is diagnosed as long as ones articular cartilage is still fairly intact. Ill def refer friends and family! Two weeks today I had meniscus root repair. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. Meniscal Root Repair Alone or Combined with Different Procedures After Realize that, as discussed above, the torn part of your meniscus was removed. Posterior Meniscal Root Repair Using a Meniscal Suture Device What was going to help my knee? You'll begin a graduated rehabilitation protocol. Also, I had to make numerous visits to the Ochsner Clinic due to my injury and Dr. Burnham's team and the staff at Ochsner were always very professional and courteous. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. PDF Knee Arthroscopy Meniscus Root Surgery FAQ - Twin Cities Orthopedics Their sense of compassion and understanding is more than we have ever experienced. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. Contact Dr. Nwachukwus team today! It can be very difficult to interpret an MRI after a meniscus root repair. But you need to still continue doing a few things to make sure that you get that remaining 20% healed so that you can truly get back to normal so let me give you some practical advice here three things that i want you to take away from this video number one set your expectations. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. 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. I did a few jungle gym rows, and finished with planks. 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 The feeling that your knee is giving way, locking, or catching when you bend it. Regular assessment of gait to avoid compensatory patterns. Never disregard or delay professional medical advice in person because of anything on HealthTap. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. I have two good arms, and a good leg. Placing sutures or UltraTape on each side of the tear and pulling it down into tunnels should be a safe and reliable method for a bony avulsion root repair. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. If youre watching this video today, and youre considering having a meniscus surgery for your knee, then youll want to listen closely so that you dont make this mistake after you have your meniscus surgery. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. Dr. Burnham performed my hip pin surgery and it all went extremely well. The thoughtful, open communication and treatment was everything I could have asked for pre-, during, and now post surgery. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. Oct 24, 2020. I never met a doctor and his team that showed some much compassion about their patient. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. So go check out that video on how to exercise your glutes theres five exercises in there that you can start doing them i would do them every day i do them a couple times a day even more if you can i would do what you can tolerate without it being too much soreness and your glute muscles and they should all generally be okay on your knee theres some where you got to kneel you can adjust it you can not do that exercise if you want. Being aware of the location of the meniscal attachments at the time of ACL and PCL surgeries is essential to minimize the chance of an iatrogenic root tear. The meniscus root attachment is important because if the meniscus becomes detached, it can squirt out of the joint, called extrusion, which can lead to the meniscus not being functional. 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. 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. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. The length of time until patients are able to return to driving varies . Meniscus root repair rehab will usually start 1-2 days after surgery. Therefore, we then looked at surgical techniques and due to the fact that we had multiple second look arthroscopies after bone grafting for ACL reconstructions with meniscus root tears, that the 1-tunnel technique had more of a spot welding healing of the meniscus to bone whereas the 2-tunnel meniscus root repair technique had a much better healing surface of the meniscus to bone. 3 0 obj 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. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. Sometimes the meniscus damage occurs more gradually as part of degeneration. We have published and validated our results in the peer-reviewed literature, which was at the time the largest series of meniscus root repairs reported. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. There can be many factors which can potentially cause pain after a meniscus root repair. Is this normal? I press and bench with no modifications. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. 5 stars! with time whether there is healing or not. He has repaired both of my shoulders and he is awesome to the max. In fact 2 years ago I finished climbing the top 100 peaks in CO. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. Meniscal root tears: Solving the silent epidemic - Journal of Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. 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? They are also important to the stability and function of the knee, keeping the meniscus in place. Now my intent on this video is not to throw anybody under the bus surgeons are doing the best they can with what they know and saw our physical therapists in any health care providers that you may be seeing for your meniscus problem. 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. The posterior roots are the most important as this is where a root tear occurs most commonly. while avoiding unnecessary surgery, injections, and medications. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). The other aspect that needs to be evaluated is the amount of extrusion of the meniscus. 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. I finally decided to make an appointment with a knee specialist. It was glorious. Meniscus root tears - a devastating injury - Dr. Bu Balalla It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. If I had not spent the last several years of my life squatting, benching, pressing and deadlifting, I would not have had the strength to continue to be as active as I was after my surgery, and I most certainly would not have known how to rehab my knee on my own. If not even worse. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. Medial Meniscus Posterior Root Repair Using a Transtibial Technique Deconditioning of ones quadriceps muscles can also cause similar symptoms, so it is important to determine if one has any atrophy of their thigh muscles, usually measured as the thigh circumference 15 cm above the patella and compared to the opposite leg. Few tears will become. Tuesday: 8:00 am 5:00 pm This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. Dr. Robert F. LaPrade operated on my right knee in May of 2010. PDF Knee meniscus root repair - tcomn.com The torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. 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. Thus, when one does sustain a lateral meniscus root tear with an ACL tear, consideration should be given to having a concurrent lateral meniscus root repair so the ACL graft does not stretch out. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. Dr Jeremy Burnham has a great way of interacting with his patients. 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. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. His team is prompt, thorough, and fun - always smiles. This specific type of tear makes up 90% of all meniscal root tears. Meniscus Surgery: What to Expect at Home - Alberta Call your doctor or 911 if you think you may have a medical emergency. Thanks to his staff for being so helpful. Heel lift in opposite shoe to normalize gait. No swelling. 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. Post Operative Knee Arthroscopy FAQs - Complete Orthopedics Your subscription could not be saved. 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. Dr Garcia demonstrates his new meniscal extrusion technique - YouTube An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. I highly recommend Dr Burnham for your orthopedic needs hands down. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. Treating a Meniscus Tear With Physical Therapy - Verywell Health We are so grateful for you both! The healing phase is long, but he does A+ work. 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. What is the Recovery Time for Meniscus Tear Surgery? - SportsMD I am now adding 10 pounds a week to the bar for squats. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. 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. What could you eat or do for a meniscus tear to heal faster after 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. Two days after my surgery, Diego took me to my first PT session. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Dr. Burnham and his staff were/are amazing. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE A week later, I got my MRI results and I was told that this was going to be a very long recovery, but I had other plans. Can you tear your meniscus again after a surgery and if you do how can you tell? I really like and appreciate the time and effort he commits to research. Treatment Outcomes of Meniscal Root Tears: A Systematic Review Most importantly, I have not missed a single coaching or training session since my surgery. 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. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. The why answer is that the meniscus root is an important stabilizer to the meniscus to ensure that it can function as effectively as possible as a shock absorber. (it is still a bit swollen). My name is Dr. David Middaugh. Many patients do not have significant joint line pain like a typical meniscus tear, so having a patient stand up and squat down is often performed during the clinical exam to validate that the patient may have a meniscus root tear. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. 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. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. stream The most important thing as one gets older is the quality of the cartilage present. 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. 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. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. 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. Dr. Burnham and Jerrica are AMAZING! 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. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. This step involves making a surgical incision or extending a previous surgical incision (such as with an ACL reconstruction) and ensuring that one is dissected down directly to bone. 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. By using our website, you consent to our use of cookies. Dr. Burnham made sure I knew what was happening and what could happen. 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. I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. 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. They moved my knee a bit, and I had decent ROM, better than expected. 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. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Instead of wall slides, I opted for high box squats. Meniscus tears & repairs - Overview - Mayo Clinic Orthopedics & Sports BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Browse archives. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. This answers all my questions! Takes his time with you and doesn't hurry to rush out of the room if you have questions. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! He diagnosed the problem quickly and accurately. 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. xYIoH8(Jr@fI)/_U}|xW&JDIraqm It helps to be strong, my PT remarked. 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. Are you an athlete who participates in sports that involve running and jumping? Kyle D. Morgenstern, MD . He answered all of my concerns about my knee. The study, " Patients Who Undergo Rotator Cuff Repair Can Safely Return to Driving at 2 Weeks Postoperatively ," was published online on July 21, 2022 in the Journal of Bone & Joint Surgery. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. The procedure can be a complete meniscectomy where the meniscus and the . 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. I can run, bike, & climb mountains. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. Figure 5:: Cortical fixation of transtibial meniscal root repair. Are you a candidate for a meniscal root repair? %PDF-1.5 Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. We recommend the use of 2 cannulas such that the meniscus can be pulled down over a broader area and have a better chance of healing to the bone. 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.