I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. Is this a tear? The most common root repair technique is called a transtibial technique. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. You will feel tired for several days. 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. 4 0 obj Kyle D. Morgenstern, MD . endobj A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. United States. 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. 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. 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. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! I recommend him, as well as his staff, to anyone requiring such services. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. 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. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. Few tears will become. Usually, pain is minimal after this type of surgery. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. But if we are stronger, we are harder to break, and we most certainly recover faster and better. 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. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. If you're an athlete needing a doctor that understands; this is the guy. Amazing Doctor and wonderful staff!! I dont remember how or when I tore my meniscus. The aftercare and recovery require postoperative protection to allow healing. The next portion of the Smith & Nephew root repair device is a mini First-Pass device. It was tough, and it hurt like hell, but I took it slowly. The therapists were a little surprised to see me so soon after my surgery, but I really wanted to know how much range of motion I had post-surgery. My wait time for office visits has always been less than 10 minutes. Each horn is anchored to the bone at the meniscus root (anterior and posterior). 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. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. These radial root tears are equivalent to a meniscus root tear. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . 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. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. The length of time until patients are able to return to driving varies . 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. 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. Meniscus Repair. A possible cause for knee pain 1 year after meniscus surgery would be a re-tear of the meniscus. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. This is because the signs of arthritis are usually pain and swelling with activities. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. Created for people with ongoing healthcare needs but benefits everyone. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. The mini First-Pass device allows placement of either a suture or an UltraTape through the substance of the meniscus, capturing the end of the stitch as it is placed through the meniscus and then it can be pulled out of the joint. I could no longer deadlift from the floor, and was having trouble squatting below parallel. Partial weightbearing status (<50%), unless otherwise ordered by MD. Types of root tears: With an injury like this you want the best, and Dr. Burnham is the best. I really like and appreciate the time and effort he commits to research. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. And slowly, I started bending the knee more, and eventually took the box away from my bench. 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. I hung on to this MRI referral for a good month or so, because the knee was starting to feel better, and I was still able to train and attend my BJJ classes. Later that day, I trained. HSS Sports Medicine Institute West Side After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. His staff is very friendly and upbeat, knowledgeable and thorough. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the And then after the surgery, the focus is doing physical therapy, typically if he gets sent there, and youre going to lose some motion in the surgery so your knee wont be able to bend or straighten all the way. Most meniscus root tears require surgery. (Please keep reading below for more information on this treatment.). Do minor meniscus tears require surgery or can it repair itself? 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 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. It has been found that one suture alone for the repair does not work well, so a minimum of 2 sutures is required to maximize meniscal healing. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. dressing in 48 hrs and may let them drive Everyone made us feel comfortable, and they were all polite and professional. And the good news is that it can be helped without another surgery. This can occur in up to 20% of patients, even in the best of circumstances. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. 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. Currently, there are mini First-Pass devices that curve to the right and the left, which allows increased access to a root tear, especially since most root tears tend to squirt to the back part of the joint and can be more difficult to access with a straight biter. 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. MRI is used to look more closely at the meniscus and determine if it is something that needs surgical treatment, although not all meniscus root tears show up on MRI. I think my clients thought I had lost my mind, but what else was I going to do? 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. Really cares for his patients! 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. Contact Dr. Nwachukwus team today! He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. 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. 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. But its just not common knowledge to take six to 12 months to heal after a meniscus surgery. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . You can't walk right after surgery. 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. 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. 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. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. 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. And its a lot slower for the remaining, you know, six to nine months after the first two or three months. A meniscus can become damaged due to sudden trauma. Many meniscus tears can be treated successfully without surgery. So you need to just have that expectation right now if youre going to go get a surgery, or if youve already had one, if its been more than six months, or youre in that you know, past six months, six to 12 months range or longer since your meniscus surgery, then its okay as long as you dont have another tear or some other massive injury to it, you can probably get that swelling under control, regain your motion back as long as it hasnt been too long. 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. Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. Meniscus root tears usually occur in patients with deep flexion such as skiers, or home gardeners, plumbers, or carpet layers or people doing similar activities. These two steps are considered to be the two main preparation steps, where the release of adhesions to be able to allow the meniscus to be pulled back in the joint and also decortication of bone to prepare a bony bed to repair the meniscus back to the tibia. Protect repair Minimize pain Minimize swelling 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. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. 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. 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. I left my visit feeling very comfortable with where I was and what needed to happen next. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. My experience with Dr. Burnham and his staff was exceptional. Dr. Burnham was very personable and explained my situation in great detail. questions after your surgery, during business hours call 763-302-2231. 1) You must be off narcotic medications for a . When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. . Prior to that, they are recommended to use crutches. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. To accomplish this goal, Dr. Nwachukwu drills a small hole from the outside of the tibia (shin bone) into the knee joint next to the natural attachment of the meniscus root. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. Are you an athlete who participates in sports that involve running and jumping? Wednesday: 8:00 am 5:00 pm Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. Very reassuring, showed me X-rays and explained the healing process very clearly. Previous attempts to make it better provided only temporary relief. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). When I went in arthroscopically and thoroughly released the meniscus, pulling it back into an anatomic position and revising the repair; all of these patients seemed to have much improved pain relief. 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. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. They walked me through the process from beginning to end. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. 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. I limped from the wedding venue to the car, and then from the car to my house. I highly recommend him. Two important criteria exist to begin driving after meniscus surgery. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. In particular, it has been found that one of the most common reasons why younger patients need total knee replacements is because of a neglected or undiagnosed meniscus root tear leading to the development of osteoarthritis. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. 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. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. . I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Robert LaPrade, MD, PhD Two weeks. And thats all good if youre going to end up having the surgery. Two weeks to the day, I got on my spin bike at the gym and did what I could do. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. Full recovery usually takes 6 months but can take up to 1 year. 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. My name is Dr. David Middaugh. Heel lift in opposite shoe to normalize gait. 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. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. % My name is Dr. David Middaugh. His team is prompt, thorough, and fun - always smiles. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. I also found that there were patients being referred to me who had meniscus root repairs that were done well, but the meniscus was not pulled back in the joint and these patients continued to have pain. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. His surgery and recovery has been perfect! 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. 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. But the next day, I woke up and literally ran down my stairs. Figure 5:: Cortical fixation of transtibial meniscal root repair. 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. You may need to leave a message. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. 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 . 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. Healing kind of goes fast the beginning and then it tapers off. In January of this year, I finally decided to go back to my doctor to get that MRI. El Paso, Texas 79903. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . Call your doctor or 911 if you think you may have a medical emergency. Great doctor. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. Instead of wall slides, I opted for high box squats. 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. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. At the beginning of April, I was dancing at a friends wedding when I suddenly heard and felt a loud pop in my left knee. Strength. Meniscal Ramp Lesions. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . Swelling and stiffness. 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.
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