Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 It is vital that meniscus repair patients do not squat for at least four months after the repair. I recommend him, as well as his staff, to anyone requiring such services. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. 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. I went to Dr. Burnham for issues I was having with my shoulders. Very professional! The general published success rate for a meniscus root repair is between 80% and 85%. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. You can't walk right after surgery. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Rehabilitation Guidelines for Meniscal Repair of Root and Complex Tears 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. Please subscribe to this channel and turn on your notifications so that you dont miss a single video with great tips and advice that we put out every single week. Therefore, we then looked at surgical techniques and due to the fact that we had multiple second look arthroscopies after bone grafting for ACL reconstructions with meniscus root tears, that the 1-tunnel technique had more of a spot welding healing of the meniscus to bone whereas the 2-tunnel meniscus root repair technique had a much better healing surface of the meniscus to bone. 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. drive the next day if they feel ok. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. Hands down would recommend him!! Dr. Burnham & his staff are very personable & caring. 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. And now theyre kind of back to the way they were before the surgery. The knee buckled and I thought, Shit. I really like and appreciate the time and effort he commits to research. 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. It can be very difficult to interpret an MRI after a meniscus root repair. This may be recommended depending on the type of meniscus tear. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. Will Walking on a Torn Meniscus Make It Worse? Injury Care - Healthline My name is Dr. David Middaugh. 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 . It has now been demonstrated that the results of meniscectomies are almost the same as not treating the meniscus root tear at all with a large number of patients within 5 years proceeding to needing a total knee arthroplasty. 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. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. 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. Each horn is anchored to the bone at the meniscus root (anterior and posterior). A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. 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. There can be many factors which can potentially cause pain after a meniscus root repair. 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. A meniscus root tear occurs when one or both of these roots tear away from the bone. The pain during my recovery has actually only been minimal, requiring no pain meds. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. Meniscal Root Repair Alone or Combined with Different Procedures After Meniscus Repair. 4. 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. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. Meniscus repair rehab protocol. 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. 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. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. His MA Michelle was very professional and kind. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Thanks to Dr. Burnham and his staff. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . Meniscus Root Repair Fairfax, Virginia | Meniscal Root Tears Washington, DC We are so grateful for you both! Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. I wasnt taking any pain medication either, so I was alert. For this reason, much research has gone in to meniscus root repairs over the last several years. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. After meniscal surgery, rehabilitation with a physical therapist or athletic trainer is needed to restore range of motion, strength, movement control and guide the athlete's return to sport. They are also important to the stability and function of the knee, keeping the meniscus in place. Dr. Burnham has an awesome bedside manner. 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. 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. % The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. Monday: 8:00 am 5:00 pm Later that day, I trained. On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. Meniscus Surgery: What to Expect at Home - Alberta There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. Medial Meniscus Posterior Root Repair Using a Transtibial Technique 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. 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. Recovery Tips After Meniscus Surgery - Kellie Middleton, MD Meniscal root avulsions are a challenging injury causing meniscal extrusion and loss of hoop stress distribution, which can lead to the development of knee arthritis.1 Securing the meniscus in a small bone socket has proven to be an effective means to restore hoop stresses and improve outcomes.2 The FlipCutter II reamer and meniscal root marking hook allow for a minimally invasive . I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. 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. 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. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. There was absolutely no knee pain. Your care after surgery may involve: Crutches to take stress off the knee as it heals. 3 0 obj In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. PDF Meniscal Root Repair Post-operative Rehabilitation Protocol A meniscus can become damaged due to sudden trauma. 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 . Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. Browse archives. 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. 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. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. 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. That means that the remaining meniscus is smaller, but still taking the same pressure. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. But youre also not alone. short distances based on their motion and The average pain levels after a meniscus root repair fit between a basic knee arthroscopy (minimal pain) and an ACL reconstruction (more severe pain). Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. 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. 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. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. It was glorious. Is this normal? Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. How Long Will My Knee Hurt After Meniscus Surgery Therefore, we found that non-anatomic meniscus root tear repairs were not successful. And slowly, I started bending the knee more, and eventually took the box away from my bench. Meniscal repair may be performed either by open surgery under direct vision or minimally invasively using an arthroscope that can be inserted into the knee through a very small key-hole incision to locate and repair the damaged meniscus. Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4 weeks postop. Why would I? This is because a lack of meniscus attachment at the root causes extra stress to be placed on an ACL graft and it can also result in the patient having more instability, both with anterior tibial translation, and with twisting and turning activities during the pivot shift, when there is a concurrent lateral meniscus root tear. My experience with Dr. Burnham and his staff was exceptional. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. Other non-medical modalities may help, such as using ice and elevating the leg. And this channel is dedicated to helping people stay healthy, active and mobile. So go check out that video on how to exercise your glutes theres five exercises in there that you can start doing them i would do them every day i do them a couple times a day even more if you can i would do what you can tolerate without it being too much soreness and your glute muscles and they should all generally be okay on your knee theres some where you got to kneel you can adjust it you can not do that exercise if you want. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. The knee will be swollen for 2-3 months. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? My name is Dr. David Middaugh. 181 West Meadow Drive Suite 400 Vail, CO 81657. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Meniscus Root Repair Northeast Philadelphia, PA | Meniscal Root Tears Dr. Burnham is amazing. When a torn fragment is floating in the joint, patients will feel a sudden, sha twitter.com/i/web/status/1, According to an injury study done in 2021, #Pickleball has been deemed safer than #tennis and better for individual twitter.com/i/web/status/1, Cysts Acetabular Paralabral and Subchondral, ACL Anterior Cruciate Ligament Injury of the Knee, Patellofemoral Pain Syndrome Runners Knee, PVNS of the Knee Pigmented Villonodular Synovitis, Osteochondral Allograft Transplantation Surgery (OATS), Patellofemoral Arthroscopy Runners Knee Treatment, Stabilization for Instability-Arthroscopic, Subacromial Decompression for Impingement, How to prevent common skiing and snowboarding injuries | Ski Injury Doctor Manhattan, BICMD Co-Founder and Co-CEO Announces Expansion of Services, Patients are partial weight bearing for the first 4 weeks and then during weeks 4-6 are progressed to full weight-bearing. 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. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. Video chat with a U.S. board-certified doctor 24/7 in a minute. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. The study included 351 patients with knee OA and meniscus tear. . I highly recommend Dr Burnham for your orthopedic needs hands down. 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. Is this a tear? While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. They walked me through the process from beginning to end. 2700 Vikings Circle And cartilage is one of the slowest healing tissues in the body. Meniscus repair recovery While everyone's recovery is different, here's what you can typically expect with a repair surgery: You may be on crutches for four to six weeks. And Im a specialist physical therapist El Paso manual physical therapy. This hoop stress is resisted by fibers that run circumferentially through the meniscus. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. General anesthesia and a nerve block. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. Full recovery from meniscus surgery can take anywhere from six weeks to three months. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. When Is Driving Safe After Rotator Cuff Repair? Really a national leader in sports medicine! The American Journal of Sports Medicine. However, if the meniscus re-tore or is placed into a non-anatomic position and ones cartilage surfaces are still fairly intact, an attempt at a revision repair should be made. Amazing Doctor and wonderful staff!! 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. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. If so, you may be at risk of tearing the root of your meniscus. Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. I have been walking and training normally for the past four and a half months. He had knee surgery a few months ago and is recovering remarkably well. Meniscus Tear Surgery Recovery Time: When Can I Get Back to Work? Meniscus Root Tear Repair | Orthopedic Knee Surgeon | Manhattan, New Two weeks to the day, I got on my spin bike at the gym and did what I could do. Usually, pain is minimal after this type of surgery. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. Definitely recommend. Meniscus Root Repair Rexburg ID | Meniscal Root Tears Rexburg ID 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. 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. He answered all my questions satisfactorily and his entire staff were polite and professional. The meniscus is a very important piece of cartilage in the knee. Driving After A Meniscus Repair : MeniscusInjuries - reddit Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? 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. 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? But the next day, I woke up and literally ran down my stairs. The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. We have published on several of these, noting that a PCL tunnel which is placed too close to the joint can detach the posterior horn of the medial meniscus and lead to the development of arthritis of the medial compartment.
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