The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. In patients who have open growth plates, consideration may be necessary to either plan to remove the sutures after the meniscus root repair heals or to consider placing the tunnels and suture repair above the growth plate such that is does not cross the growth plate and have a theoretical chance of causing a growth plate arrest. 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. My repair will be later this week on my right leg. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. Two weeks. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. The healing phase is long, but he does A+ work. 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. I dont remember how or when I tore my meniscus. 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. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. 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. Post Operative Knee Arthroscopy FAQs - Complete Orthopedics Previous attempts to make it better provided only temporary relief. 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. I am so glad I did! Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. Thanks to Dr. Burnham and his staff. I decided right then and there I would not get the MRI. He provided a thorough explanation without wasting time. 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. PDF Rehabilitation Guidelines for Meniscal Repair of Root and Complex Tears Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. 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. There can be many factors which can potentially cause pain after a meniscus root repair. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. In addition, if the medial meniscus is involved, active After a pretty serious car accident, Dr. Burnham performed knee surgery on me. But typically physical therapy goes two to three months you get 80% better and a lot of times people have the expectation setting themselves that they can get back to everything that theyre doing before and thats just not the case they can do a lot of things now that they couldnt before the surgery typically. The Steadman Clinic - Edwards, CO A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. This answers all my questions! There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. Two important criteria exist to begin driving after meniscus surgery. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! Some patients may experience catching, clicking, or locking of their knee. Partial weightbearing status (<50%), unless otherwise ordered by MD. 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. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. 2601 E. Yandell Drive, Suite 232 How long do you have to avoid driving after meniscus tear surgery Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. 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. I rate him 5stars. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. And if youve already had your meniscus surgery, then you know what to do so that youre not getting more swelling, pain and not losing motion than that knee and youre staying out of the surgeons office, so you dont have to go back again for another knee surgery. The Biggest Mistake People Make After Knee Meniscus Surgery I am now adding 10 pounds a week to the bar for squats. 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. There are 2 main variants of the transtibial root repair technique. The general published success rate for a meniscus root repair is between 80% and 85%. United States. 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. My calf swelled up into my ankles. I highly recommend him. He will now be caring for my hip and knee in the future. Your care after surgery may involve: Crutches to take stress off the knee as it heals. Rehabilitation Guidelines for Meniscal Repair of Root and Complex Tears Begin passive range of motion exercises Start physical therapy or home exercise program 1-3 days after surgery Work on quad recruitment Brace/Crutch Use 25% weight bearing with crutches, brace 0-90 when ambulating and sleeping, can remove . I have been walking and training normally for the past four and a half months. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. 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. Tuesday: 8:00 am 5:00 pm 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 And this channel is dedicated to helping people stay healthy, active and mobile. 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. 3 0 obj This is done to protect the repair and let the body heal it. 2700 Vikings Circle Dr. Burnham performed my hip pin surgery and it all went extremely well. Treating a Meniscus Tear With Physical Therapy - Verywell Health Knows his stuff. endobj 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. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. And Im a specialist physical therapist El Paso manual physical therapy. For more information on meniscus root tears of the knee and meniscus root repair surgery, please contact the office of Benedict Nwachukwu, MD, orthopedic knee specialist serving Manhattan, New York City and the surrounding New York boroughs. Can You Walk Immediately After Meniscus Surgery? - eMedicineHealth While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? I would highly recommend him. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). Patients often report hearing a pop at the time of injury. 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. <>/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>> I chose not to use my crutches anymore. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. I never met a doctor and his team that showed some much compassion about their patient. Full recovery usually takes 6 months but can take up to 1 year. This specific type of tear makes up 90% of all meniscal root tears. endobj Prior to Starting Strength, I would have simply gone to physical therapy, done my exercises like the therapist told me to do, and that would have been it. The other aspect that needs to be evaluated is the amount of extrusion of the meniscus. Meniscus Root Tear | Knee Doctor | Baton Rouge, LA - Jeremy Burnham, MD Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 Being stronger is always better than being weak. This can occur with turning, twisting, or pivoting activities or sports. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. There are two menisci in the knee, medial and lateral. We had a wonderful experience and I highly recommend him. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. I got rid of the box for squats the end of July. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . Very positive experience at Bone and Joint Clinic in Baton Rouge. Specializes in Orthopedic Reconstructive Surgery. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. 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. If one does a meniscus root repair in that extruded position, the chance of a meniscus root repair working over the long term is very minimal. In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint. Patients \50 years had outcomes similar to those of patients !50 years, as did . 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. First, one needs to ensure that the meniscus root is repairable and that there is not too much arthritis on that affected portion of the joint such that a meniscus root repair would not be recommended. 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. 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. PDF Knee meniscus root repair - tcomn.com I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. 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. Meniscus Root Repair Northeast Philadelphia, PA | Meniscal Root Tears I wont ever go anywhere else. I really like and appreciate the time and effort he commits to research. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. Meniscus Surgery: Who Needs It, What to Expect Before & After Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone). Is this a tear? Meniscus Post Surgery Rehabilitation 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. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. It was glorious. Types of root tears: I think my clients thought I had lost my mind, but what else was I going to do? And Im a specialist physical therapist El Paso manual physical therapy. Ill def refer friends and family! Meniscal Root Repair | Meniscal Root Injury |Orthopedic Knee Surgeon . After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. Meniscal root repair whether isolated or in combination with valgus HTO or ACL reconstruction, when indicated, was able to improve the clinical, functional and subjective results of the patients presented in this case series. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. Dr. Burnham was very thorough with his examination and diagnosis. Your doctor put a lighted tubecalled an arthroscope or scopeand other surgical tools through small cuts (incisions) in your knee. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. Meniscus root repair | Knee Problems | Forums | Patient He then drills a hole from the front of the tibia, into the root area and brings the sutures through the hole in order to tie them together and hold the tissue in place. What could you eat or do for a meniscus tear to heal faster after surgery? 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. 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 kept training, modifying my squatting as needed until I could get back to proper depth. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. When Is Driving Safe After Rotator Cuff Repair? My daughter recovered fully from a total knee reconstruction and now she able to return to sports. His surgery and recovery has been perfect! Everyone made us feel comfortable, and they were all polite and professional. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. Meniscus root repair rehab will usually start 1-2 days after surgery. One should assess the range of motion at that point in time that can be performed in a safe zone to make sure that the physical therapist does not flex them harder in this time frame. Meniscus Root Repair - Joint Replacement Patient Forum And cartilage is one of the slowest healing tissues in the body. Meniscus root tears are a particularly troublesome type of meniscus tear, because a failure to treat them can often result in the rapid development of osteoarthritis. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. HSS Sports Medicine Institute West Side A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. In addition, because of studies from our biomechanical studies showing significant stress on the meniscus with deep flexion, as well as the fact that many meniscus root tears occur with deep flexion, we have patients avoid squatting, squatting and lifting and sitting cross-legged (which puts extra stress on a root repair) for a minimum of 4 months postoperatively to maximize the healing potential. 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. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . endobj And they can get back to normal in about two or three months after having the surgery. The knee will be swollen for 2-3 months. They moved my knee a bit, and I had decent ROM, better than expected. Kyle D. Morgenstern, MD . 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. They are connected to your tibia by meniscal roots. Well, this is not normal. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Patients are allowed to walk 4-6 weeks after surgery. So lets get to it. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. 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. with time whether there is healing or not. If I could give more than 5 stars, I would. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients Most meniscus root tears require surgery. Very thorough, knowledgeable and courteous. 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. Meniscus Root Repair - Joint Replacement Patient Forum 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. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. These include 1-tunnel and 2-tunnel techniques. 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. The pain during my recovery has actually only been minimal, requiring no pain meds. 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. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). General anesthesia and a nerve block. 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. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Meniscal root tears: Solving the silent epidemic - Journal of A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. 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. Definitely a Bakers Cyst, my doctor said when I saw him. During our biomechanical testing, we found that if we tied the sutures directly over bone, with cyclic loading, the sutures would cut into the bone and the repair would become loose over time. But now I know more about the body, about rehab, and about what being stronger really means. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. 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.
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