I was going to rehab myself, and keep training as normally as I could. amount of, supply and beyond the age of 15 has limited healing without surgery. 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. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. I dont remember how or when I tore my meniscus. What made my recovery so fast? I am now adding 10 pounds a week to the bar for squats. Using specific guides to ensure that one can place tunnels in the anatomic position and using self-capture devices, which have been devised to be small enough to not scuff up the cartilage, are some of the best means to perform a transtibial meniscus root repair with self-capture devices. 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. 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. These radial root tears are equivalent to a meniscus root tear. 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 it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. Many meniscus tears can be treated successfully without surgery. Being aware of the location of the meniscal attachments at the time of ACL and PCL surgeries is essential to minimize the chance of an iatrogenic root tear. I definitely know that I would not have been able to do all that I can do now, if I had not gone into the surgery strong. They are also important to the stability and function of the knee, keeping the meniscus in place. We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. I decided to continue with my usual four day split with two upper body days and two lower body days, although I did also incorporate a few extra upper body exercises as my lower body work was not that intense. 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. A torn meniscus can result in either sudden or gradual onset of pain. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). The swelling started to go down, but there was now a lump behind my knee that felt like fluid. That means that the remaining meniscus is smaller, but still taking the same pressure. 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. One should not look at age as a factor for meniscus root repairs. Later that day, I trained. That night, I drove myself to the gym. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. 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. 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. By far the best orthopedic team I have ever met. Tuesday: 8:00 am 5:00 pm In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. 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. We had a wonderful experience and I highly recommend him. 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. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. 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. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. 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. Weight bearing as tolerated after 6 weeks. If patients put weight on the knee immediately after the repair, the forces on . Later that summer, the left knee began to bother meagain. I got rid of the box for squats the end of July. 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. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. 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. Doctors typically provide answers within 24 hours. I highly recommend him. Dr. Burnham and his staff were/are amazing. Thank you Dr. Burnham and Jerrica for everything! If youre watching this video today, and youre considering having a meniscus surgery for your knee, then youll want to listen closely so that you dont make this mistake after you have your meniscus surgery. with time whether there is healing or not. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. 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. Thank you for choosing Dr. LaPrade as your healthcare provider. The aftercare and recovery require postoperative protection to allow healing. 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. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. 4 0 obj After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. What was going to help my knee? We are so grateful for you both! With an injury like this you want the best, and Dr. Burnham is the best. This allows the meniscus to heal back to the bone. Can you tear your meniscus again after a surgery and if you do how can you tell? I left my visit feeling very comfortable with where I was and what needed to happen next. The meniscus root is where the meniscus attaches to bone. while avoiding unnecessary surgery, injections, and medications. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. He answered all my questions satisfactorily and his entire staff were polite and professional. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. The most common complication after a meniscus root repair is a re-tear. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . Other non-medical modalities may help, such as using ice and elevating the leg. % If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. 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 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. For this reason, much research has gone in to meniscus root repairs over the last several years. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? You'll begin a graduated rehabilitation protocol. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. But now I know more about the body, about rehab, and about what being stronger really means. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. 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. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. Oct 24, 2020. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Highly recommended! Is this normal? Following this 6 weeks, they begin weight bearing at 25% with crutches for 1 week, and then 75% weight bearing using 1 crutch for 1 additional week. They are also important to the stability and function of the knee, keeping the meniscus in place. 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. 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. He and his staff could not have been more helpful and professional. %PDF-1.5 This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. Dr. Burnham took his time and answered all my questions with explanations. I have been walking and training normally for the past four and a half months. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. 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. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. The procedure can be a complete meniscectomy where the meniscus and the . And thats the 80% fact is true that does happen. <> Hands down would recommend him!! 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. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. 5 stars! You have two roots per meniscus which include anterior and posterior roots. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Fortunately, this is usually done arthroscopically and with good results. There was absolutely no knee pain. You can't walk right after surgery. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. 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. It helps to be strong, my PT remarked. My experience with Dr. Burnham and his staff was exceptional. An ACL tear commonly has a pop on the outside of the knee, whereas a patient who has meniscus root tear commonly feels a pop in the back of the knee. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. 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. I started Brazilian Jiu-Jitsu about four years ago. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. Heres the third practical tip if youre if you dont know where to go Ive got some exercises that i put on videos here for free on YouTube its linked in the description below theres one video in particular that i want you to take a look at its called top five glute exercises for knee problems go check out that video start doing those exercises youve got to exercise the heck out of your glutes if you got a meniscus injury if youve had a meniscus surgery in the past you need to get your glutes worked out. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! 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. Some patients may experience catching, clicking, or locking of their knee. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . Dr Jeremy Burnham has a great way of interacting with his patients. 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. I felt very informed and well cared for. Thanks to his staff for being so helpful. He provided a thorough explanation without wasting time. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. Robert LaPrade, MD, PhD A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. Phase I of Rehab: Surgery until 8 weeks. I press and bench with no modifications. But youve got to figure out a way to get your butt muscles stronger if youre looking for a more comprehensive plan for making your knee better and getting your glutes stronger we also have a program called the 28 day knee health and wellness boost program you can also find that in the link and as a link in the description below. 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. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. I limped from the wedding venue to the car, and then from the car to my house. Protect repair Minimize pain Minimize swelling 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. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. But the next day, I woke up and literally ran down my stairs. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. General anesthesia and a nerve block. The following Tuesday, I saw my doctor. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. Two weeks to the day, I got on my spin bike at the gym and did what I could do. Never disregard or delay professional medical advice in person because of anything on HealthTap. Yet, if you feel discomfort, you can take over-the-counter pain medication. endobj 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. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? A meniscus that still has extrusion present also does not function as well over the long term. The meniscus is a very important piece of cartilage in the knee. 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. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. I had a traumatic knee injury that he performed surgery on. (it is still a bit swollen). 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. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. And thats all good if youre going to end up having the surgery. 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. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. 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. Being stronger is always better than being weak. This technique is fast and effective. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist.
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