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. My repair will be later this week on my right leg. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. I wont ever go anywhere else. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in 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. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. The drill tip can then be pulled out, leaving the cannula in place, which allows one to place a passing stich up it to subsequently shuttle sutures down the tibial tunnel. 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. Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. 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. 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. What to do if I have a radial meniscus tear, what's the chance of it fully healing with surgery? This technically challenging procedure should only be done by an orthopedic knee expert like Dr. Nwachukwu who has had extensive experience in performing the meniscal root tear repair correctly. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? 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. 181 West Meadow Drive Suite 400 Vail, CO 81657. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. The posterior roots are the most important as this is where a root tear occurs most commonly. 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. 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. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. 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. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. 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. Yet, if you feel discomfort, you can take over-the-counter pain medication. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. Tuesday: 8:00 am 5:00 pm Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? We love you! Your subscription could not be saved. Figure 5:: Cortical fixation of transtibial meniscal root repair. 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. Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. I walked around the gym with the crutches, and without the crutches. Really a national leader in sports medicine! A surgical guide can then be placed in a drill tip where the cannula around it is placed into the area of the decorticated bone. Partial weightbearing status (<50%), unless otherwise ordered by MD. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. Browse archives. But if we are stronger, we are harder to break, and we most certainly recover faster and better. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. What could you eat or do for a meniscus tear to heal faster after surgery? 2018;47:762. 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. 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. Thank you for choosing Dr. LaPrade as your healthcare provider. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. These include 1-tunnel and 2-tunnel techniques. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. Most importantly, I have not missed a single coaching or training session since my surgery. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. 1 0 obj In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Some patients may experience catching, clicking, or locking of their knee. Definitely a Bakers Cyst, my doctor said when I saw him. Most of these types of injuries, that are symptomatic, require surgery. The most common complication after a meniscus root repair is a re-tear. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. United States. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. 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. Very professional! 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. Most meniscus root tears require surgery. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. 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. And then they lose motion. 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. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. And they can get back to normal in about two or three months after having the surgery. Meniscus root repair surgeon, Doctor Benedict Nwachukwu provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, New York City, NY who need meniscus root repair surgery. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. 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. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. 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. Dr. Burnham is amazing. Full recovery usually takes 6 months but can take up to 1 year. It takes longer for a meniscus repair to heal than a meniscectomy. And cartilage is one of the slowest healing tissues in the body. <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 12 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. This may be recommended depending on the type of meniscus tear. (B) Posterior root lesion of lateral meniscus. short distances based on their motion and Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. 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. These radial root tears are equivalent to a meniscus root tear. I would have relied strictly on physical therapy. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. In fact 2 years ago I finished climbing the top 100 peaks in CO. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . 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. Prior to that, they are recommended to use crutches. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. The healing phase is long, but he does A+ work. Driving after meniscus root repair depends on which knee it is. Dr. Burnham and his staff were/are amazing. Strength. Video chat with a U.S. board-certified doctor 24/7 in a minute. 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. And get the pain under control and recover normally the way that you should have once you start doing the right things. In some severe cases, they cant fully extend their knee out or bend their knee all the way. Few tears will become. It can create another problem later on youve got to listen to your knee youve got to listen to your body and make sure that you only go with what you can tolerate without making it worse without swelling pain or definitely not losing motion and you might consider staying in physical therapy longer than they want you to or finding something to help you out. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. The procedure can be a complete meniscectomy where the meniscus and the . Oftentimes, after having a meniscus surgery, people are told that they'll be fine. importance of the meniscus root has become more apparent. <>>> Patients \50 years had outcomes similar to those of patients !50 years, as did . His staff is very friendly and upbeat, knowledgeable and thorough. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. I highly recommend Dr Burnham for your orthopedic needs hands down. I got rid of the box for squats the end of July. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. Recommend highly. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. This can occur in up to 20% of patients, even in the best of circumstances. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. 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. For this reason, much research has gone in to meniscus root repairs over the last several years. 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. endobj The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . I recommend him, as well as his staff, to anyone requiring such services. He answered all my questions satisfactorily and his entire staff were polite and professional. 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. If patients put weight on the knee immediately after the repair, the forces on . A torn meniscus can result in either sudden or gradual onset of pain. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. You may need to leave a message. If scar tissue is present, Dr. Nwachukwu will clean up the area so the knee is allowed to move through its entire range of motion. Dr. Burnham took his time and answered all my questions with explanations. The second step is to prepare a bony bed where the meniscus repair will be performed. This allows the meniscus to heal back to the bone. 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. 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. Strength is one of the most important aspects of our lives. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. The . Is this normal? I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. Two weeks. Meniscus Repair. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. 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 was very thorough with his examination and diagnosis. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. As of August 20, 2019, it will be six months post-op. The meniscus is a cushion of the knee joint. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. You may need surgery to restore full knee function. And this channel is dedicated to helping people stay healthy, active and mobile. I kept training, modifying my squatting as needed until I could get back to proper depth. I highly recommend him. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. My name is Dr. David Middaugh. Monday: 8:00 am 5:00 pm Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? Hands down would recommend him!! I highly recommend him. The best surgeon is Baton Rouge that actually care about his patients!!! Doctors typically provide answers within 24 hours. 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. Great doctor. The American Journal of Sports Medicine. Procedure for Meniscus Root Repair. Patients often report hearing a pop at the time of injury. A meniscus root tear usually will not heal on its own. He answered all of my concerns about my knee. By far the best orthopedic team I have ever met. Why would I? He then drills a hole from the front of the tibia, into the root area and brings the sutures through the hole in order to tie them together and hold the tissue in place. 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. Contact Dr. Nwachukwus team today! His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. I could no longer deadlift from the floor, and was having trouble squatting below parallel. Meniscal Repair. 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. He spent a great amount of time explaining everything to me in a way that I understood everything. while avoiding unnecessary surgery, injections, and medications. I had a traumatic knee injury that he performed surgery on. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Regular assessment of gait to avoid compensatory patterns. You'll likely regain your previous muscle strength in the leg by. Heel lift in opposite shoe to normalize gait. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. 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. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? 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. 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. 2700 Vikings Circle I press and bench with no modifications. 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. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. 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. 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. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist.