HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. 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. Is this normal? I felt very informed and well cared for. Then I trained. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Monday: 8:00 am 5:00 pm Dr Burnhams bedside manner was exceptional. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Dr Jeremy Burnham has a great way of interacting with his patients. This can occur in up to 20% of patients, even in the best of circumstances. He is amazing and a blessing to have in the medical industry. The system also involves a drill with a cannula whereby one can drill through the tibial guide, see the drill bit come out inside the knee, and then pull the drill bit out and leave the cannula in place. 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. I am now adding 10 pounds a week to the bar for squats. The transtibial meniscal root repair is emerging as the gold standard treatment due to its ability to restore a large footprint at the meniscal root's native attachment site and restore normal joint contact pressures. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. 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. Strength. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. 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 walked me through the process from beginning to end. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. I was very pleased seeing Dr. Burnham, however I was not pleased to learn I was expected to pay an additional co- pay within the same week to receive the results of my MRI. Instead of wall slides, I opted for high box squats. I would highly recommend him. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . 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 . Super knowledgeable. A meniscus root tear requires the meniscus to be repaired back to the lower leg bone; this is also performed arthroscopically. What made my recovery so fast? 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. Driving after meniscus root repair depends on which knee it is. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Country. A lateral meniscus root tear involves a tear of the meniscus either at or close to the root attachment in the back part of the lateral meniscus. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. 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. Protect repair Minimize pain Minimize swelling 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. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. 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. Thanks to his staff for being so helpful. There was absolutely no knee pain. Thank you Dr. Burnham for being so amazing! 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 answered all my questions satisfactorily and his entire staff were polite and professional. And slowly, I started bending the knee more, and eventually took the box away from my bench. 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. We will determine during your consultation whether general or regional anesthesia would be appropriate - either way, no pain will be experienced during the procedure itself. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. By using our website, you consent to our use of cookies. His surgery and recovery has been perfect! The following Tuesday, I saw my doctor. What was going to help my knee? Identifying and properly treating meniscus tears (with or without surgery) will lead to the most rapid reduction in your symptoms and is crucial to optimize the long term health of your knee. 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. importance of the meniscus root has become more apparent. A meniscus root tear occurs when one or both of these roots tear away from the bone. 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. A possible cause for knee pain 1 year after meniscus surgery would be a re-tear of the meniscus. I have no issues taking the stairs, just a little knee discomfort here and there. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Nothing. In addition, if the medial meniscus is involved, active The second tip i need you to take home today is you need to listen to your knee because after youre on your own and youre youre supposed to be 80% better theres things that youll be able to do and go ahead and do those as long as they dont hurt or bother you or cause some effects later on that day or the next day then theyre generally going to be okay things for you to do you can probably do some walking but walking you know a few miles maybe not very comfortable for you that may set off the swelling that may hurt you more. They are also important to the stability and function of the knee, keeping the meniscus in place. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). Typically begins 3-5 days after surgery; Precautions Toe touch weight bearing with brace; Gradually unlock brace for 6 weeks; after 6 weeks no brace After about five minutes, the wheels were spinning. A meniscus that still has extrusion present also does not function as well over the long term. United States. He had knee surgery a few months ago and is recovering remarkably well. And Im a specialist physical therapist El Paso manual physical therapy. Patients \50 years had outcomes similar to those of patients !50 years, as did . What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. In some severe cases, they cant fully extend their knee out or bend their knee all the way. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . Because this is a frequent question posed on Google, I will try to be modest in answering this. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. 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. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. The meniscus is a cushion of the knee joint. (it is still a bit swollen). It was glorious. The meniscus is a piece of cartilage in the knee, often injured in sports. 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 This is one of the first video demonstrations of this. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Most patients with meniscal root tears will ultimately need surgical fixation of the root. I have see all three orthopedic doctors at the Grove and Jerrica is the one I see the most and the latest she's absolutely wonderful. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. endobj I consulted with SSC and DPT Darin Deaton prior to my surgery and then afterwards, when I discovered it had been a meniscus root repair. I highly recommend Dr Burnham for your orthopedic needs hands down. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. This answers all my questions! Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? I was going to rehab myself, and keep training as normally as I could. After hours 763-520-7870 Address Maple Grove 9630 Grove Circle N., Suite 200 Maple Grove, MN 55369 Minnetonka 15450 Highway 7, Suite 100 Minnetonka, MN 55345 Robbinsdale 3366 Oakdale Ave. N Suite 103 Robbinsdale, MN 55422 Knee Meniscus Root . 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. Never disregard or delay professional medical advice in person because of anything on HealthTap. And cartilage is one of the slowest healing tissues in the body. 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. Ill def refer friends and family! He has repaired both of my shoulders and he is awesome to the max. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. Definitely a Bakers Cyst, my doctor said when I saw him. 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. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. 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? dressing in 48 hrs and may let them drive So that means youre good to go after two to three months. Meniscus Repair. I went to Dr. Burnham for issues I was having with my shoulders. 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. The posterior roots are the most important as this is where a root tear occurs most commonly. I decided right then and there I would not get the MRI. Two important criteria exist to begin driving after meniscus surgery. 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. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. These radial root tears are equivalent to a meniscus root tear. I got a lift home, and returned to the gym later that evening for more coaching. It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. 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. This is important because these repairs are still quite tenuous with current technology, so it is important to try to put the meniscus back into a position where there would not be a lot of tension on the repair with knee range of motion. It is vital that meniscus repair patients do not squat for at least four months after the repair. These are totally different. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. 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. We had a wonderful experience and I highly recommend him. The protocol is divided into phases. Dr. Burnham has an awesome bedside manner. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. They explain things very well. This allows the meniscus to heal back to the bone. Created for people with ongoing healthcare needs but benefits everyone. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. It was tough, and it hurt like hell, but I took it slowly. This hoop stress is resisted by fibers that run circumferentially through the meniscus. This technique is fast and effective. 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. Many tears have better outcomes if they are treated early. And they can get back to normal in about two or three months after having the surgery. I kept training, modifying my squatting as needed until I could get back to proper depth. Two weeks today I had meniscus root repair. Swelling and stiffness. If patients put weight on the knee immediately after the repair, the forces on . This is because the signs of arthritis are usually pain and swelling with activities. 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. El Paso, Texas 79903. Later that summer, the left knee began to bother meagain. You can schedule an office consultation with Dr. LaPrade. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . Please try again. He is on the cutting edge of research and techniques around surgery, he has a memorably reassuring bedside manner, and Im thankful he was in charge of my evalution and treatment. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. 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. I wasnt taking any pain medication either, so I was alert. I hope that you found hope now that if you got if you had a meniscus surgery in the past and youre dealing with these problems of swelling the pain the loss of motion please start doing this this taking this advice that i gave you start doing the exercises and get better it is possible to get that swelling down and to get your motion back and to recover and be normal. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. Life happens and our bodies will sometimes let us down. Recommend highly. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. 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. How long did you have to avoid driving after meniscus surgery? And this channel is dedicated to helping people stay healthy, active and mobile. The meniscus root is where the meniscus attaches to bone. So if youre sitting at home right now, and you just had your meniscus surgery a month or two ago, and youre thinking, gosh, why arent I much better already. By far the best orthopedic team I have ever met. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. You will begin to focus on regaining your ROM and begin more in muscle strengthening. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. This may be recommended depending on the type of meniscus tear. 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. Dr. Burnham made sure I knew what was happening and what could happen. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. He answered all of my concerns about my knee. 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. 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. 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. 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. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. (B) Posterior root lesion of lateral meniscus. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. This allows the meniscus to heal back to the bone. W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. I would like to thank Dr. Jeremy Burnham for his wonderful work and surgery on my left shoulder. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). 515 Ray C. Hunt Drive, Suite 1100, Charlottesville, VA 22903 Phone: 434-243-7778 Fax: 434-243-5075 Meniscal Root Repair Post-operative Rehabilitation Protocol. 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. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. Fig 1 (A) Meniscus 4 A-II device. I'm able to run and exercise without pain. 5 stars! He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. 2601 E. Yandell Drive, Suite 232 The next portion of the Smith & Nephew root repair device is a mini First-Pass device. When I woke up I was in significant pain but the nurses had it under control by the time I left. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. drive the next day if they feel ok. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. Each horn is anchored to the bone at the meniscus root (anterior and posterior). Repair of the meniscal root significantly increased functional outcomes scores in 14 of 14 studies and the rate of conversion to TKA was considerably less than those observed following conservative treatment or partial meniscectomy. I have been walking and training normally for the past four and a half months. 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. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. I did a few jungle gym rows, and finished with planks. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. I wont ever go anywhere else. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. One of the main portions of the system is a guide that can be placed inside the joint that fits around the tibial eminences and allows the surgeon to place the tip of the guide right at the area that has been decorticated of bone, where one wants to perform the root repair tunnel. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. 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. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. 4 0 obj 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. Thank you. . It is our goal to provide the highest level of care and service to our patients. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. I asked when I could start driving, and he said when I was off my pain medication. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients
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