And thats the 80% fact is true that does happen. Being stronger is always better than being weak. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. I chose not to use my crutches anymore. 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. 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. 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. endobj Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. This can occur with turning, twisting, or pivoting activities or sports. 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. 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. Deconditioning of ones quadriceps muscles can also cause similar symptoms, so it is important to determine if one has any atrophy of their thigh muscles, usually measured as the thigh circumference 15 cm above the patella and compared to the opposite leg. 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. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. One should not look at age as a factor for meniscus root repairs. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. 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 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. Definitely a Bakers Cyst, my doctor said when I saw him. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. Amazing Doctor and wonderful staff!! Dr. Burnham is amazing. Meniscal Ramp Lesions. 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. The knee buckled and I thought, Shit. Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. 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. The following Tuesday, I saw my doctor. The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. Specializes in Orthopedic Reconstructive Surgery. Strength. Dr Jeremy Burnham has a great way of interacting with his patients. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. But if we are stronger, we are harder to break, and we most certainly recover faster and better. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. You'll likely regain your previous muscle strength in the leg by. The American Journal of Sports Medicine. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. These are totally different. One patient was noted to have an insufficiency fracture and spontaneous osteonecrosis of the knee (SONK) as part of the root tear and came in in a wheelchair and she has had6 years of successful return to activities after her meniscus root repair, including hiking and cycling. Sometimes the meniscus damage occurs more gradually as part of degeneration. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. . 1) You must be off narcotic medications for a . It is shaped like a C and it serves to cushion and stabilize the knee. I finally decided to make an appointment with a knee specialist. When I said I was not on any medication, he said when I could bend my leg 90 degrees. The meniscus is a very important piece of cartilage in the knee. Patients are allowed to walk 4-6 weeks after surgery. There was absolutely no knee pain. When you put weight on your leg, it is the meniscal roots that transfer the axial loading forces of the knee into hoop stress in the meniscus. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Browse archives. This answers all my questions! Prior to that, they are recommended to use crutches. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. So happy I found them! The feeling that your knee is giving way, locking, or catching when you bend it. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. 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. Is this a tear? Very professional! 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. 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. Created for people with ongoing healthcare needs but benefits everyone. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . His surgery and recovery has been perfect! He answered all my questions satisfactorily and his entire staff were polite and professional. 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. It can also occur while bending the knee deeply. Full recovery from meniscus surgery can take anywhere from six weeks to three months. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. For this reason, much research has gone in to meniscus root repairs over the last several years. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. However, we felt that with a 6-week period of being nonweightbearing important for all meniscus root tears, that the 2 simple suture technique was valid. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. 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. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. 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. Super knowledgeable. Instead of wall slides, I opted for high box squats. (it is still a bit swollen). You may need surgery to restore full knee function. And if youve never worked out your glutes if you went through physical therapy never really targeted your glutes ever you better start quick because chances are youve got a muscle imbalance thats caused extra pressures inside your knee thats led to that meniscus tear to begin with thats been the root problem and glute strength is what offsets that forces inside the knee so that your meniscus can heal all the way. So its important at the very beginning its appropriate at the very beginning to make sure that all your emotions back and that you can do some simple walking to and from the house even though hurts so that youre not you know having accidents and better so youre not having emergencies happening you need the function of your leg back. Do minor meniscus tears require surgery or can it repair itself? I walked around the gym with the crutches, and without the crutches. Therefore, it is strongly recommended to proceed with a meniscus root repair whenever possible, with patients up to the age of 70 being reported as having excellent return of function. 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. Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. I felt very informed and well cared for. You may need to leave a message. You will feel tired for several days. My surgery was at 8:30am Wednesday, February 20. I would like to thank Dr. Jeremy Burnham for his wonderful work and surgery on my left shoulder. 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. It was press/bench day, so I set up for some seated presses and dragged a stool over to prop my left leg up while I benched. Two weeks. 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. Robert LaPrade, MD, PhD Nothing. If you had a knee surgery if youve been seen physical therapy or any other health care professionals and theyre telling you youll be fine in three months back to normal youll be dancing youll be exercising youll be playing with the grandkids again just smile and remember this video. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? Normally, you should refrain from driving for at least 1 week after an arthroscopic knee operation, until the swelling reduces and the knee motion improves, but you should establish with your doctor when it is safe to start driving. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. 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. That was day one. 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. Then I trained. Realize that, as discussed above, the torn part of your meniscus was removed. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. Later that day, I trained. I got rid of the box for squats the end of July. Oct 24, 2020. We recognized that meniscus root tears were a problem over 10 years ago and set out to perform a comprehensive research program to help us figure out how to diagnose the problem, where to place the meniscus repair, and how best to fix the meniscus tear to allow for maximal healing capability. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. But now I know more about the body, about rehab, and about what being stronger really means. In addition, there is no low age for meniscus repairs, with some root repairs being done in patients as young as 6 or 7 years old. 2018;47:762. Thus, when one does sustain a lateral meniscus root tear with an ACL tear, consideration should be given to having a concurrent lateral meniscus root repair so the ACL graft does not stretch out. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. Dr. Burnham took his time and answered all my questions with explanations. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. 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. 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. Ibuprofen (Advil, Motrin) Naproxen (Aleve) It was tough, and it hurt like hell, but I took it slowly. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. endobj And Im a specialist physical therapist El Paso manual physical therapy. 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. 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. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. 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. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? The why answer is that the meniscus root is an important stabilizer to the meniscus to ensure that it can function as effectively as possible as a shock absorber. Definition/Description. 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. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. He and his staff could not have been more helpful and professional. Dr. Burnham was very thorough with his examination and diagnosis. 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 would highly recommend him. 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.