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. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. The RICE (rest, ice, compression, elevation) principle can be useful in the first several days after a meniscus tear to help reduce inflammation, swelling, and pain. Using specific guides to ensure that one can place tunnels in the anatomic position and using self-capture devices, which have been devised to be small enough to not scuff up the cartilage, are some of the best means to perform a transtibial meniscus root repair with self-capture devices. If the lateral meniscus root tear is not repaired at the same time as an ACL reconstruction, it is now recognized that this could lead to ACL graft failure or loosening over 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. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. 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. And get the pain under control and recover normally the way that you should have once you start doing the right things. 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. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. Life happens and our bodies will sometimes let us down. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. When I woke up I was in significant pain but the nurses had it under control by the time I left. 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. The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. 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. Easy to talk to and will answer any questions of your care. 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. A meniscus root tear usually will not heal on its own. Figure 5:: Cortical fixation of transtibial meniscal root repair. Just its a big deal to take your time and let that cartilage heal at the rate that it heals you generally can go faster than what it heals, And the question that i get often is do i take any supplements glucosamine chondroitin those types of supplements and you know the answer to that is its not going to hurt we the research is kind of mixed on it sometimes it helps sometimes it doesnt help what we know is that it generally doesnt hurt it doesnt make it worse so youre not going to youre not going to make things worse if you decide to take those supplements are generally safe to take but some people report no difference. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. I switched from trap bar deadlifts to barbell rack pulls, continued to lower the box for squats and switched from single leg deadlifts to RDLs. Very positive experience at Bone and Joint Clinic in Baton Rouge. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. I decided right then and there I would not get the MRI. You have two roots per meniscus which include anterior and posterior roots. 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. The procedure can be a complete meniscectomy where the meniscus and the . The aftercare and recovery require postoperative protection to allow healing. Driving after meniscus root repair depends on which knee it is. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. 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. 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. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. You can schedule an office consultation with Dr. LaPrade. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. There are two menisci in the knee, medial and lateral. I chose not to use my crutches anymore. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. 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. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. 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. Medication may be needed for 2-3 weeks. I would like to thank Dr. Jeremy Burnham for his wonderful work and surgery on my left shoulder. Video chat with a U.S. board-certified doctor 24/7 in a minute. There are some isolated reports of using suture anchors to repair a meniscus root repair, but this area of the knee is very difficult to access and the suture anchors can leave large knots which could subsequently interfere with the cartilage surfaces in the knee. Two weeks. Dr. Burnham clearly cares about his patients and their follow up care. Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. As of August 20, 2019, it will be six months post-op. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. 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. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. 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. This can occur in up to 20% of patients, even in the best of circumstances. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. 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 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. In January of this year, I finally decided to go back to my doctor to get that MRI. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. He is amazing and a blessing to have in the medical industry. 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. Types of root tears: Edina, MN 55435, EAGAN-VIKING LAKES OFFICE 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. So that means youre good to go after two to three months. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). Dr. Burnham was very personable and explained my situation in great detail. 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. (Please keep reading below for more information on this treatment.). My wait time for office visits has always been less than 10 minutes. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. The torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. Most patients with meniscal root tears will ultimately need surgical fixation of the root. The meniscus root is where the meniscus attaches to bone. I have been very pleased with him at each visit..It's been almost 2 years since my meniscus root tear surgery and I have to say my knee feels great. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. (B) Posterior root lesion of lateral meniscus. I highly recommend Dr Burnham for your orthopedic needs hands down. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. The most common complication after a meniscus root repair is a re-tear. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. We love you! Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Untreated meniscus tears can increase in size and lead to complications, such as arthritis. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. Many tears have better outcomes if they are treated early. Very reassuring, showed me X-rays and explained the healing process very clearly. 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. If patients put weight on the knee immediately after the repair, the forces on . And thats all good if youre going to end up having the surgery. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. 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. This technically challenging procedure should only be done by an orthopedic knee expert like Dr. Nwachukwu who has had extensive experience in performing the meniscal root tear repair correctly. HSS Sports Medicine Institute West Side On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. 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. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. His surgery and recovery has been perfect! This results in premature arthritis and cartilage damage in the knee. Dr. Burnham is amazing. He answered all of my concerns about my knee. 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. A written consent will be obtained from you after the surgical procedure has been explained in detail. Does having a cortisone shot help a meniscus tear or is surgery the only option? 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. In cases the patients undergo meniscus repair or ligament reconstruction, they are given a brace to support the knee in full extension. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. Two days after my surgery, Diego took me to my first PT session. Do minor meniscus tears require surgery or can it repair itself? His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. 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. 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. Well, this is not normal. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. This allows the meniscus to heal back to the bone. And cartilage is one of the slowest healing tissues in the body. 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? Amazing Doctor and wonderful staff!! Can you tear your meniscus again after a surgery and if you do how can you tell? Being stronger is always better than being weak. 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. I finally decided to make an appointment with a knee specialist. Normally, you should refrain from driving for at least 1 week after an arthroscopic knee operation, until the swelling reduces and the knee motion improves, but you should establish with your doctor when it is safe to start driving. My surgery was at 8:30am Wednesday, February 20. They can occur in younger patients as a result of high energy trauma, but are more common in patients between 45 and 60 as a result of degeneration of the meniscus with age. Monday: 8:00 am 5:00 pm We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. Few tears will become. Procedure for Meniscus Root Repair. My experience with Dr. Burnham and his staff was exceptional. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. 4010 W. 65th St. 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. And slowly, I started bending the knee more, and eventually took the box away from my bench. 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. 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. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . I'm able to run and exercise without pain. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. These two steps are considered to be the two main preparation steps, where the release of adhesions to be able to allow the meniscus to be pulled back in the joint and also decortication of bone to prepare a bony bed to repair the meniscus back to the tibia. 2700 Vikings Circle This is because the signs of arthritis are usually pain and swelling with activities. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. When these are torn, the loading of the joint is equivalent to having no meniscus on the affected side. Highly recommended! Is this a tear? 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. Heres the third practical tip if youre if you dont know where to go Ive got some exercises that i put on videos here for free on YouTube its linked in the description below theres one video in particular that i want you to take a look at its called top five glute exercises for knee problems go check out that video start doing those exercises youve got to exercise the heck out of your glutes if you got a meniscus injury if youve had a meniscus surgery in the past you need to get your glutes worked out. 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. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. (it is still a bit swollen). 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. He spent a great amount of time explaining everything to me in a way that I understood everything. Dr. Burnham and his staff were/are amazing. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. With an injury like this you want the best, and Dr. Burnham is the best. Meniscal Repair. 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. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. repair to heal. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. <>/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>> 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. Dr Burnham is so personable. For this reason, much research has gone in to meniscus root repairs over the last several years. 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. 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. Meniscus root repair rehab will usually start 1-2 days after surgery. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Therefore, it is strongly recommended to proceed with a meniscus root repair whenever possible, with patients up to the age of 70 being reported as having excellent return of function. I recommend him, as well as his staff, to anyone requiring such services. 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. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. Hands down would recommend him!! Is this normal? The length of time until patients are able to return to driving varies . Knee popping after meniscus surgery can occur due to fluid accumulation, scar tissue, swelling and stretching of the tendon and ligaments, weakened leg muscles, changes in patellar tracking, underlying knee arthritis, unstable meniscus, and inflamed plica. And this channel is dedicated to helping people stay healthy, active and mobile. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. 1 0 obj Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . If not even worse. Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. He diagnosed the problem quickly and accurately. Really a national leader in sports medicine! Great shoulder doc. We are so grateful for you both! Had a meniscus root repair yesterday and the surgery was successful. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. Contact Dr. Nwachukwus team today! Your care after surgery may involve: Crutches to take stress off the knee as it heals. Dr. Burnham took his time and answered all my questions with explanations. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. 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. No swelling. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. I hung on to this MRI referral for a good month or so, because the knee was starting to feel better, and I was still able to train and attend my BJJ classes. Rehabilitation begins within a week of surgery. I started Brazilian Jiu-Jitsu about four years ago. Strength is one of the most important aspects of our lives. There are many factors that go into this, including a patients weight, with overweight patients putting more stress on the meniscus root tear, ones alignment, where one being bowlegged with a medial meniscus root repair putting extra stress on the repair, and also the amount of underlying arthritis present prior to the root repair. He listens and address every concern with appropriate solutions. There goes my knee again.. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. Instead of wall slides, I opted for high box squats. It is shaped like a C and it serves to cushion and stabilize the knee. The next day, my left knee blew up to the size of a grapefruit. Created for people with ongoing healthcare needs but benefits everyone. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Because this is a frequent question posed on Google, I will try to be modest in answering this. 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. I wasnt taking any pain medication either, so I was alert. His MA Michelle was very professional and kind. Protect repair Minimize pain Minimize 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. The exception is a patient that has contra-indications to surgery or already has too much cartilage wear and tear for the root repair to be beneficial. 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. 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. My name is Dr. David Middaugh. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? Darin helped me understand that it was going to be a very slow recovery due to the nature of the surgery, and to be patient. We had a wonderful experience and I highly recommend him. In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint.