4010 W. 65th St. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. If the surgery is on the right leg i change to It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. 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 procedure can be a complete meniscectomy where the meniscus and the . And its a lot slower for the remaining, you know, six to nine months after the first two or three months. Created for people with ongoing healthcare needs but benefits everyone. very elderly patients). Knows his stuff. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. A meniscus that still has extrusion present also does not function as well over the long term. His surgery and recovery has been perfect! His team is prompt, thorough, and fun - always smiles. The goal of a meniscus root tear repair is to locate the torn root and tack it back down to the bone using strong sutures. Kyle D. Morgenstern, MD . 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 also started boxing sessions once a week with one of my coaches as I am not allowed to start back to BJJ until September. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. The protocol is divided into phases. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. I have now biked five to six days each week since my surgery. I chose not to use my crutches anymore. I finally decided to make an appointment with a knee specialist. Meniscus root repair is a surgery performed to repair a torn meniscus root. Contact Dr. Nwachukwus team today! Definition/Description. 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. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . If the patient has or has developed significant arthritis, which is usually designated at Kellgren-Lawrence grades 3 or 4, it is felt that a revision root repair may not be indicated. 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. Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4 weeks postop. I got a lift home, and returned to the gym later that evening for more coaching. 181 West Meadow Drive Suite 400 Vail, CO 81657. The most common complication after a meniscus root repair is a re-tear. You can schedule an office consultation with Dr. LaPrade. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. If one has too much arthritis, then the chance of a meniscus root repair helping one to slow down the progression of arthritis is probably not worth having the meniscus root repaired. endobj 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. Please try again. We had a wonderful experience and I highly recommend him. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. 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. 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. My wait time for office visits has always been less than 10 minutes. My name is Dr. David Middaugh. 5 stars! Two weeks to the day, I got on my spin bike at the gym and did what I could do. Rehabilitation begins within a week of surgery. 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. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? It is shaped like a C and it serves to cushion and stabilize the knee. Dr. Burnham and his staff were/are amazing. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. Dr Burnhams bedside manner was exceptional. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). 3 0 obj Really a national leader in sports medicine! 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. If the lateral meniscus root tear is not repaired at the same time as an ACL reconstruction, it is now recognized that this could lead to ACL graft failure or loosening over time. Untreated meniscus tears can increase in size and lead to complications, such as arthritis. Thank you for choosing Dr. LaPrade as your healthcare provider. I started Brazilian Jiu-Jitsu about four years ago. Strength. These radial root tears are equivalent to a meniscus root tear. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. The most important thing as one gets older is the quality of the cartilage present. 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. 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. I press and bench with no modifications. 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. Later that summer, the left knee began to bother meagain. importance of the meniscus root has become more apparent. 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 knee will be swollen for 2-3 months. A meniscus root tear can occur due to a traumatic event or degeneration. Therefore, our surgical technique, using specific guides to avoid the eminences to ensure that one can place the guide exactly where one wants to have a cannula come out in the joint, using cannulas to allow for placement of passing sutures quickly and efficiently, having 2 separate cannulas with 2 separate tunnels for the meniscus repair, releasing the meniscus thoroughly to pull it back in the joint so it functions most effectively, and then having self-capture suture devices, which can place suture or tape into the meniscus substance, shuttle them down the tibia, and then tie them over a metal button on the tibia. My name is Dr. David Middaugh. Fortunately, this is usually done arthroscopically and with good results. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. The meniscus is a piece of cartilage in the knee, often injured in sports. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. Dr. Burnham clearly cares about his patients and their follow up care. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? 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. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. And I feel my rode to recovery will be wonderful. Request Case Review or Office Consultation, Lateral Patellotibial Ligament Reconstruction, Anatomic Analysis of the Posterior Root Attachments of the Menisci, Posterior Root Avulsion Fracture of the Medial Meniscus, Not Your Fathers (or Mothers) Meniscus Surgery, Anterior Intermeniscal Ligament of the Knee An Anatomical Study, Popliteomeniscal Fascial Tears Causing Symptomatic Lateral Compartment Knee Pain, Prospective Outcomes Study of Meniscal Allograft Transplantation. Oct 24, 2020. 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. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. This is because the signs of arthritis are usually pain and swelling with activities. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. 4. 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. As a result, two weeks after surgery I was able to start driving my car, which is a manual. Other sources of pain can include scarring within the joint that occurs as a normal part of a surgical procedure, or pain from other pathology and joint, such as arthritis under the kneecap. Usually, pain is minimal after this type of surgery. Very professional! Wednesday: 8:00 am 5:00 pm My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. 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. 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. My pain was gone. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. The American Journal of Sports Medicine. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. Patients are allowed to initiate weightbearing at 6 weeks, but should avoid any significant squatting, squatting and lifting, or sitting cross-legged for a minimum of 5-6 months. <> The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. If patients put weight on the knee immediately after the repair, the forces on . Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. He answered all my questions satisfactorily and his entire staff were polite and professional. 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. Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. Protect repair Minimize pain Minimize swelling I would have relied strictly on physical therapy. I am now adding 10 pounds a week to the bar for squats. 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 was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. They are also important to the stability and function of the knee, keeping the meniscus in place. In some severe cases, they cant fully extend their knee out or bend their knee all the way. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. Regular assessment of gait to avoid compensatory patterns. While there are a small number of patients who do have their meniscus root re-tear, this has been nowhere near as common as the other sources noted above. 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. #JimmyWinkfield is 1 of 5 men to win the prestigious twitter.com/i/web/status/1, What are #loosebodies in the #hip? A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. 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. The meniscus root is where the meniscus attaches to bone. There are 2 main variants of the transtibial root repair technique. I would highly recommend him. 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. I rate him 5stars. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. An iatrogenic meniscus root tear means that a tunnel was drilled for an ACL or PCL reconstruction and hit the meniscus root and detached it from bone. This may be recommended depending on the type of meniscus tear. Phase I of Rehab: Surgery until 8 weeks. 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 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. Thank you Dr. Burnham for being so amazing! Hence, that remaining meniscus is more and not less likely to tear again. Some patients may experience catching, clicking, or locking of their knee. He answered all of my concerns about my knee. dressing in 48 hrs and may let them drive 2018;47:762. 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. With an injury like this you want the best, and Dr. Burnham is the best. Later that day, I trained. 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. They explain things very well. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. Video chat with a U.S. board-certified doctor 24/7 in a minute. Meniscal Repair. Progression of range of motion is more limited than for a standard meniscus root repair, usually limiting patients to 0-60 or 0-90 degrees range of motion for the first 4 weeks and then slowly increasing range of motion as tolerated. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. 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. 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. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. Repetitive motions, overuse, and muscular imbalances ar twitter.com/i/web/status/1, Digging Deeper into the Data: Is Suture Bridge Repair + #PRP really the best technique for #rotatorcuffrepair? twitter.com/i/web/status/1, Wild Life of the Last #BlackJockey to Rule the #KentuckyDerby 2601 E. Yandell Drive, Suite 232 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. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. 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. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 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. #12. 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. Stated to me , in detail, what to expect and how long my recovery will take. 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. When a tear of the meniscal root, or even a tear near the root, occurs, the meniscus can no longer convert axial loading forces into hoop stresses. Life happens and our bodies will sometimes let us down. His MA Michelle was very professional and kind. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Dr. Burnham made sure I knew what was happening and what could happen. The best surgeon is Baton Rouge that actually care about his patients!!! 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 average pain levels after a meniscus root repair fit between a basic knee arthroscopy (minimal pain) and an ACL reconstruction (more severe pain). The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. The feeling that your knee is giving way, locking, or catching when you bend it. 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. This specific type of tear makes up 90% of all meniscal root tears. 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. I recommend him, as well as his staff, to anyone requiring such services. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned.
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driving after meniscus root repair