Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Non-anatomic root repairs do not restore normal joint biomechanics . I think my clients thought I had lost my mind, but what else was I going to do? It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. Can you tear your meniscus again after a surgery and if you do how can you tell? Dr. Burnham was very helpful for my injury! After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. If not even worse. My repair will be later this week on my right leg. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root 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. Thus, these patients can often have early onset arthritis, the development of bony edema, insufficiency fractures, and the failure of concurrent cruciate ligament reconstruction grafts. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. 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. 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. I'm taking pain meds regularly to try and ease pain. In addition, the design of the meniscus is such that the full pressure of weight bearing activities is transmitted through the root of the meniscus, meaning that it is constantly pulling and stretching the tear with every step. 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. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. When I said I was not on any medication, he said when I could bend my leg 90 degrees. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. One should not look at age as a factor for meniscus root repairs. No swelling. 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. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. 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. I was going to rehab myself, and keep training as normally as I could. Please help. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . 3 0 obj He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. Dr. Burnham and his staff were/are amazing. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. 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. while avoiding unnecessary surgery, injections, and medications. Later that summer, the left knee began to bother meagain. And this channel is dedicated to helping people stay healthy, active and mobile. So getting swelling, or if its been a year since you had your meniscus surgery, and youre better overall, but youre still getting some swelling and pain, then its normal. 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. Heel lift in opposite shoe to normalize gait. His surgery and recovery has been perfect! 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. A meniscus root tear requires the meniscus to be repaired back to the lower leg bone; this is also performed arthroscopically. xYIoH8(Jr@fI)/_U}|xW&JDIraqm And people are often disappointed to find out that as they begin to get back to normal, as theyve been told that they probably could and should they start to get swelling in the knee, they start to get a pain, of course. Thanks to his staff for being so helpful. And cartilage is one of the slowest healing tissues in the body. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. 2601 E. Yandell Drive, Suite 232 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. 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. 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. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. It takes longer for a meniscus repair to heal than a meniscectomy. That means that the remaining meniscus is smaller, but still taking the same pressure. The . If there is tissue there, it usually means that the meniscus root repair has healed down to bone. This results in premature arthritis and cartilage damage in the knee. And they can get back to normal in about two or three months after having the surgery. Because this is a frequent question posed on Google, I will try to be modest in answering this. Meniscus root repair is a surgery performed to repair a torn meniscus root. That was day one. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. The length of time until patients are able to return to driving varies . I opened my gym shortly after taking up strength training in earnest to help address my back pain, and have been working for the past eight years to help others embrace their true potential and strength. Continuing to train, moving it as much as I could, bearing weight as much as I could tolerate, not sitting around, and NOT just doing PT exercises 1-2x times a week. 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. Super knowledgeable. If scar tissue is present, Dr. Nwachukwu will clean up the area so the knee is allowed to move through its entire range of motion. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. 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. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. Sometimes the meniscus damage occurs more gradually as part of degeneration. Protect repair Minimize pain Minimize swelling If I could give more than 5 stars, I would. Please try again. Highly recommended! endobj Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Meniscal Ramp Lesions. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. This can occur with turning, twisting, or pivoting activities or sports. My name is Dr. David Middaugh. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? So lets get to it. Had a meniscus root repair yesterday and the surgery was successful. Takes his time with you and doesn't hurry to rush out of the room if you have questions. Dr. Burnham was very personable and explained my situation in great detail. 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. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. The study included 351 patients with knee OA and meniscus tear. The most important thing as one gets older is the quality of the cartilage present. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . But the next day, I woke up and literally ran down my stairs. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. 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. 4 0 obj I never met a doctor and his team that showed some much compassion about their patient. 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. . To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. The incisions leave scars that usually fade in time. 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. In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. The next steps involve placing self-capture sutures into the end of the meniscus root and then drilling cannulas into the area that was decorticated such that the sutures placed into the meniscus can be shuttled down the cannulas and then tied over the tibia. 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. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Two important criteria exist to begin driving after meniscus surgery. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Therefore, the patient should be worked up in a timely fashion when they do have a posterior horn medial meniscus root tear to determine if they are a candidate for a posterior horn medial meniscus transtibial root repair. You can schedule an office consultation with Dr. LaPrade. 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. Kyle D. Morgenstern, MD . The blood supply to the meniscus in an adolescent or adult is very poor. Driving after meniscus root repair depends on which knee it is. 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. These include 1-tunnel and 2-tunnel techniques. Partial weightbearing status (<50%), unless otherwise ordered by MD. Therefore, we found that non-anatomic meniscus root tear repairs were not successful. A meniscus root tear can occur due to a traumatic event or degeneration. 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. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. 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 usually presents with pain along the inside or medial portion of the joint and with swelling with activities. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. Monday: 8:00 am 5:00 pm 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. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . 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. I got a lift home, and returned to the gym later that evening for more coaching. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. Fig 1 (A) Meniscus 4 A-II device. Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. You'll begin a graduated rehabilitation protocol. After about five minutes, the wheels were spinning. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. United States. Rehabilitation begins within a week of surgery. Other complications can include a blood clot, which is usually treated preemptively with some type of blood thinner, and irritation around the surgical button and/or surgical knot from the meniscus root tear. 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. 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. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the Few tears will become. <> The most common root repair technique is called a transtibial technique. endobj The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. We are so grateful for you both! The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone). As of August 20, 2019, it will be six months post-op. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. A written consent will be obtained from you after the surgical procedure has been explained in detail. 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. Most of these types of injuries, that are symptomatic, require surgery. Strength. Instead of wall slides, I opted for high box squats. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. Patients often report hearing a pop at the time of injury. 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. The most common method to fix meniscus root tears is through a tibial bone tunnel. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. 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. When I woke up I was in significant pain but the nurses had it under control by the time I left. Highlights from the StartingStrength Community. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. 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, https://www.epmanualphysicaltherapy.com/wp-content/uploads/2020/01/Logo-copy-1030x429.jpg, Shoulder Impingement: Everything You Need To Know To Get Healthy Again, Top 5 Shoulder Impingement Exercises To Help Get Healthy Again, Top 6 At Home Treatments To Begin To Naturally Heal Cervical Radiculopathy, Click Here To Schedule A Phone Call With An Expert, Click Here To Ask About Cost & Availability, Copyright 2022 - El Paso Manual Physical Therapy, How To Tell If Youve Got A Rotator Cuff Tear, Request A Virtual Visit With One Of Our Expert PTs, 28 day knee health and wellness boost program, 28-Day Knee Health & Wellness Boost Program, 28 Day Back Health & Wellness Boost Program. Patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs can expect a variation of the following: Dr. Nwachukwu is extremely knowledgeable about his area of expertise. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. Surgical repair can successfully allow the meniscus to heal. 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. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 2 0 obj This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. While there are many factors that can go into extrusion, a maximum attempt should be made by the surgeon to try to pull the meniscus back in the joint to give the meniscus the best chance to function as a shock absorber after it heals. . They are connected to your tibia by meniscal roots. The following Tuesday, I saw my doctor. This happens way more often than I like to admit. He will now be caring for my hip and knee in the future. I press and bench with no modifications. The recovery time for meniscus surgery depends on the type of surgery you had. 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. How long recovery takes depends on the type of meniscus surgery and the severity of the injury, but expect two weeks down time, at minimum. questions after your surgery, during business hours call 763-302-2231.

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