Dr. Burnham and his remarkable staff have been a godsend for our son. He will now be caring for my hip and knee in the future. Please try again. 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. My calf swelled up into my ankles. Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. There are many factors that go into this, including a patients weight, with overweight patients putting more stress on the meniscus root tear, ones alignment, where one being bowlegged with a medial meniscus root repair putting extra stress on the repair, and also the amount of underlying arthritis present prior to the root repair. W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. Protect repair Minimize pain Minimize swelling The Steadman Clinic - Edwards, CO 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. Typically begins 3-5 days after surgery; Precautions Toe touch weight bearing with brace; Gradually unlock brace for 6 weeks; after 6 weeks no brace 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. The RICE (rest, ice, compression, elevation) principle can be useful in the first several days after a meniscus tear to help reduce inflammation, swelling, and pain. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. There can be many factors which can potentially cause pain after a meniscus root repair. 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. In terms of how, the transtibial technique has been felt to be the most effective way to pull the meniscus root back to its normal attachment site. 4. 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. Dr. Robert F. LaPrade operated on my right knee in May of 2010. I walked around the gym with the crutches, and without the crutches. 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. Walk with crutches. He answered all of my concerns about my knee. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. The feeling that your knee is giving way, locking, or catching when you bend it. Full recovery usually takes 6 months but can take up to 1 year. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! In this technique, sutures are placed into the torn meniscus root and then shuttled down tunnels in the tibia to tie the repair into place. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. In addition, if the medial meniscus is involved, active The blood supply to the meniscus in an adolescent or adult is very poor. Meniscal Ramp Lesions. (Please keep reading below for more information on this treatment.). And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Meniscus Repair. I would have relied strictly on physical therapy. 181 West Meadow Drive Suite 400 Vail, CO 81657. 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. I have now biked five to six days each week since my surgery. Dr. Benedict Nwachukwu, orthopedic knee surgeon has extensive experience in treating meniscus root tears and can help patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs. 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. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. 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. 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. Other complications can include a blood clot, which is usually treated preemptively with some type of blood thinner, and irritation around the surgical button and/or surgical knot from the meniscus root tear. I highly recommend him. I have successfully repaired meniscus root tears in patients that were 70 and 71 years old respectively and they are some of my happiest patients. Later that day, I trained. And then they lose motion. This is done to protect the repair and let the body heal it. And theres things that you can do, which Ill allude to here in the middle. 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. In recent years the importance of the meniscus root has become more apparent. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. This is one of the first video demonstrations of this. It helps to be strong, my PT remarked. 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. Two weeks. Timeline: 1 week to 5 weeks after Surgery. 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. Two weeks today I had meniscus root repair. Meniscal Repair. But youre also not alone. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. 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. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. One should assess the range of motion at that point in time that can be performed in a safe zone to make sure that the physical therapist does not flex them harder in this time frame. 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. My name is Dr. David Middaugh. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Most meniscus root tears require surgery. So the focus of physical therapy after a knee meniscus surgery is getting your motion all the way back and then getting strong enough to stand and do some walking. By far the best orthopedic team I have ever met. There was absolutely no knee pain. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . In fact 2 years ago I finished climbing the top 100 peaks in CO. I think my clients thought I had lost my mind, but what else was I going to do? There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Everyone made us feel comfortable, and they were all polite and professional. 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. In addition, we looked at varying suture techniques through the meniscus, including 2 simple sutures, as well as other configurations of meniscus suture techniques, which are more complex. I am so glad I did! 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. The second tip i need you to take home today is you need to listen to your knee because after youre on your own and youre youre supposed to be 80% better theres things that youll be able to do and go ahead and do those as long as they dont hurt or bother you or cause some effects later on that day or the next day then theyre generally going to be okay things for you to do you can probably do some walking but walking you know a few miles maybe not very comfortable for you that may set off the swelling that may hurt you more. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. And now theyre kind of back to the way they were before the surgery. - Privacy Policy - Louisiana Retina, Dr. Jeremy Burnham, MD - Sports Medicine, Orthopedic Surgeon, Knee Doctor, Jeremy Burnham, MD - Sports Medicine & Orthopedic Surgeon, __CONFIG_colors_palette__{"active_palette":0,"config":{"colors":{"f3080":{"name":"Main Accent","parent":-1},"f2bba":{"name":"Main Light 10","parent":"f3080"},"trewq":{"name":"Main Light 30","parent":"f3080"},"poiuy":{"name":"Main Light 80","parent":"f3080"},"f83d7":{"name":"Main Light 80","parent":"f3080"},"frty6":{"name":"Main Light 45","parent":"f3080"},"flktr":{"name":"Main Light 80","parent":"f3080"}},"gradients":[]},"palettes":[{"name":"Default","value":{"colors":{"f3080":{"val":"rgb(23, 23, 22)"},"f2bba":{"val":"rgba(22, 23, 22, 0.5)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"trewq":{"val":"rgba(22, 23, 22, 0.7)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"poiuy":{"val":"rgba(22, 23, 22, 0.35)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"f83d7":{"val":"rgba(22, 23, 22, 0.4)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"frty6":{"val":"rgba(22, 23, 22, 0.2)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"flktr":{"val":"rgba(22, 23, 22, 0.8)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}}},"gradients":[]},"original":{"colors":{"f3080":{"val":"rgb(23, 23, 22)","hsl":{"h":60,"s":0.02,"l":0.09}},"f2bba":{"val":"rgba(23, 23, 22, 0.5)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.5}},"trewq":{"val":"rgba(23, 23, 22, 0.7)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.7}},"poiuy":{"val":"rgba(23, 23, 22, 0.35)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.35}},"f83d7":{"val":"rgba(23, 23, 22, 0.4)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.4}},"frty6":{"val":"rgba(23, 23, 22, 0.2)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.2}},"flktr":{"val":"rgba(23, 23, 22, 0.8)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.8}}},"gradients":[]}}]}__CONFIG_colors_palette__, Cartilage Damage: Symptoms, Causes, & Treatment, Elbow Rehabilitation and Postoperative Protocols. 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. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. Dr Burnhams bedside manner was exceptional. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). Contact Dr. Nwachukwus team today! They moved my knee a bit, and I had decent ROM, better than expected. The . I was told it would be about 6 weeks, but my instructions are to wear a brace at full extension for the duration of this time. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. The meniscus root is where the meniscus attaches to bone. The exception is a patient that has contra-indications to surgery or already has too much cartilage wear and tear for the root repair to be beneficial. On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. Yet, if you feel discomfort, you can take over-the-counter pain medication. (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. 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. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. This specific type of tear makes up 90% of all meniscal root tears. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. And get the pain under control and recover normally the way that you should have once you start doing the right things. 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. Oftentimes healthcare providers will tell you go walk your knees operated on its good youre the we took out the chunk that was you know causing your need to lock up the meniscus we did a meniscectomy or we repaired the meniscus and its all sewn together now so you can go ahead and walk all you want and some people take that to heart and to go walk you know three miles a day or even 10-20 miles a week and their meniscus just doesnt heal enough and they get that swelling. The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. 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. Kyle D. Morgenstern, MD . (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. Types of root tears: 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. 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. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. You will begin to focus on regaining your ROM and begin more in muscle strengthening. 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. 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. Two days after my surgery, Diego took me to my first PT session. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Phase I of Rehab: Surgery until 8 weeks. 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. 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. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. 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 . Strength. Does a extruded medial meniscus towards the posterior root need surgery? Non-anatomic root repairs do not restore normal joint biomechanics . The following Tuesday, I saw my doctor. My pain was gone. Instead of wall slides, I opted for high box squats. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. 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. 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. 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. Lateral meniscus root tears can lead to arthritis, but they also result in the ACL being a little looser and the clunk that comes with an ACL tear (pivot shift) being more unstable. Partial weightbearing status (<50%), unless otherwise ordered by MD. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. This technique is fast and effective. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. I can run, bike, & climb mountains. And its a lot slower for the remaining, you know, six to nine months after the first two or three months. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. 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. 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. Patients are allowed to walk 4-6 weeks after surgery. What was going to help my knee? I would recommend his services to anyone. 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. I left my visit feeling very comfortable with where I was and what needed to happen next. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. They are also important to the stability and function of the knee, keeping the meniscus in place. During our biomechanical testing, we found that if we tied the sutures directly over bone, with cyclic loading, the sutures would cut into the bone and the repair would become loose over time. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. In January of this year, I finally decided to go back to my doctor to get that MRI. 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. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. Ill def refer friends and family! Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. We currently use UltraTape to do this. What could you eat or do for a meniscus tear to heal faster after surgery? 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. You have two roots per meniscus which include anterior and posterior roots. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. He has repaired both of my shoulders and he is awesome to the max. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. 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. 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. Because this is a frequent question posed on Google, I will try to be modest in answering this. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. 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. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Dr. Burnham was very thorough with his examination and diagnosis. I wont ever go anywhere else. 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. Very positive experience at Bone and Joint Clinic in Baton Rouge. <>/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>> Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. They are also important to the stability and function of the knee, keeping the meniscus in place. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. 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. HSS Sports Medicine Institute West Side 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. 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. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. I highly recommend Dr Burnham for your orthopedic needs hands down. Dr. Burnham made sure I knew what was happening and what could happen.
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