GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! 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. The best surgeon is Baton Rouge that actually care about his patients!!! Super knowledgeable. So lets get to it. What do you suggest if my MRI says that I have a horizontal tear in the body of the lateral meniscus is shown do I need surgery? I would recommend his service to any recreational athlete. 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. 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. He had knee surgery a few months ago and is recovering remarkably well. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. If you're an athlete needing a doctor that understands; this is the guy. If one has too much arthritis, then the chance of a meniscus root repair helping one to slow down the progression of arthritis is probably not worth having the meniscus root repaired. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. (Please keep reading below for more information on this treatment.). 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. 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. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. If the surgery is on the right leg i change to I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. Thanks to his staff for being so helpful. If not even worse. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. It is our goal to provide the highest level of care and service to our patients. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 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. 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. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. He answered all of my concerns about my knee. 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. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. The most important thing as one gets older is the quality of the cartilage present. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. You can schedule an office consultation with Dr. LaPrade. Usually, pain is minimal after this type of surgery. But theres still healing to be done and that 20% is really critical. The feeling that your knee is giving way, locking, or catching when you bend it. This happens way more often than I like to admit. 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. 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. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. Meniscus repair is usually done with arthroscopic surgery. Two important criteria exist to begin driving after meniscus surgery. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. Very professional! 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. Contact Dr. Nwachukwus team today! Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Browse archives. 2601 E. Yandell Drive, Suite 232 So that means youre good to go after two to three months. Your subscription could not be saved. Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? I finally decided to make an appointment with a knee specialist. Dr. Burnham and his staff were/are amazing. Most root tears involve either a direct tear of the meniscus off bone or a split of the meniscus within 1 cm of the root attachment. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. Thank you. And its really concerning and very disappointing for somebody whos gone through the knee surgery. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . And then they lose motion. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. His staff is very friendly and upbeat, knowledgeable and thorough. . <> Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. In some cases, its important that you take away from this video today that it takes six to 12 months to heal from a meniscus surgery. Regular assessment of gait to avoid compensatory patterns. Continuing to train, moving it as much as I could, bearing weight as much as I could tolerate, not sitting around, and NOT just doing PT exercises 1-2x times a week. 2018;47:762. 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. We had a wonderful experience and I highly recommend him. We are so grateful for you both! We currently use UltraTape to do this. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. 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 . Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. Procedure for Meniscus Root Repair. 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. In some severe cases, they cant fully extend their knee out or bend their knee all the way. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. We love you! Dr Jeremy Burnham has a great way of interacting with his patients. Why would I? But youre also not alone. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. I wasnt taking any pain medication either, so I was alert. 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. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . The most common method to fix meniscus root tears is through a tibial bone tunnel. Thank you Dr. Burnham and Jerrica for everything! 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. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. Fig 1 (A) Meniscus 4 A-II device. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. After meniscal surgery, rehabilitation with a physical therapist or athletic trainer is needed to restore range of motion, strength, movement control and guide the athlete's return to sport. Ill def refer friends and family! The procedure can be a complete meniscectomy where the meniscus and the . 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. Two weeks. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. I would recommend his services to anyone. 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. I walked around the gym with the crutches, and without the crutches. dressing in 48 hrs and may let them drive Patient Testimonials - Meniscus Root Repair Everett | OCD Repair of the Knee Kirkland X Accessibility View Book An Appointment (206) 784-8833 Wallingford Office (206) 633-8100 Ballard Office (206) 784-8833 Home My Practice Practice Expertise Patient / Medical Resources Educational Resources Videos Radio/podcasts News Contact Dr. Garcia Facebook I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. In January of this year, I finally decided to go back to my doctor to get that MRI. The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. They explain things very well. The technique of a meniscus root repair involves isolating the root, placing a minimum of 2 sutures in the remaining meniscal attachment, and trying to reposition it back to a more anatomic position. 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. Driving after meniscus root repair depends on which knee it is. And the good news is that it can be helped without another surgery. 4010 W. 65th St. Thank you for choosing Dr. LaPrade as your healthcare provider. 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. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Other non-medical modalities may help, such as using ice and elevating the leg. . Most importantly, I have not missed a single coaching or training session since my surgery. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. He diagnosed the problem quickly and accurately. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. I highly recommend him. 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. An iatrogenic meniscus root tear means that a tunnel was drilled for an ACL or PCL reconstruction and hit the meniscus root and detached it from bone. 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. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE stream The meniscus root attachment is important because if the meniscus becomes detached, it can squirt out of the joint, called extrusion, which can lead to the meniscus not being functional. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. 5 stars! I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. Types of root tears: This specific type of tear makes up 90% of all meniscal root tears. 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. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. And cartilage is one of the slowest healing tissues in the body. Dr. Burnham clearly cares about his patients and their follow up care. 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. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Meniscus repair rehab protocol. And get the pain under control and recover normally the way that you should have once you start doing the right things. It was glorious. In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 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. A meniscus root tear occurs when one or both of these roots tear away from the bone. In addition, because of studies from our biomechanical studies showing significant stress on the meniscus with deep flexion, as well as the fact that many meniscus root tears occur with deep flexion, we have patients avoid squatting, squatting and lifting and sitting cross-legged (which puts extra stress on a root repair) for a minimum of 4 months postoperatively to maximize the healing potential. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. <> It is vital that meniscus repair patients do not squat for at least four months after the repair. I dont remember how or when I tore my meniscus. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. And now theyre kind of back to the way they were before the surgery. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. 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. Later that summer, the left knee began to bother meagain. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Highly recommended! Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. The healing phase is long, but he does A+ work. 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 goal of a meniscus root tear repair is to locate the torn root and tack it back down to the bone using strong sutures. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. Really cares for his patients! Because this is a frequent question posed on Google, I will try to be modest in answering this. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 This technique is fast and effective. United States. My wait time for office visits has always been less than 10 minutes. The length of time until patients are able to return to driving varies . Once my doctor started the procedure, it was obvious that this would not be a simple surgery. Swelling and stiffness. Very thorough, knowledgeable and courteous. We are so grateful and thankful. 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. Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. The following Tuesday, I saw my doctor. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. When a torn fragment is floating in the joint, patients will feel a sudden, sha twitter.com/i/web/status/1, According to an injury study done in 2021, #Pickleball has been deemed safer than #tennis and better for individual twitter.com/i/web/status/1, Cysts Acetabular Paralabral and Subchondral, ACL Anterior Cruciate Ligament Injury of the Knee, Patellofemoral Pain Syndrome Runners Knee, PVNS of the Knee Pigmented Villonodular Synovitis, Osteochondral Allograft Transplantation Surgery (OATS), Patellofemoral Arthroscopy Runners Knee Treatment, Stabilization for Instability-Arthroscopic, Subacromial Decompression for Impingement, How to prevent common skiing and snowboarding injuries | Ski Injury Doctor Manhattan, BICMD Co-Founder and Co-CEO Announces Expansion of Services, Patients are partial weight bearing for the first 4 weeks and then during weeks 4-6 are progressed to full weight-bearing. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. Medication may be needed for 2-3 weeks. In terms of when, one should plan to perform a meniscus root repair as soon as it is diagnosed as long as ones articular cartilage is still fairly intact. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. Well, this is not normal. 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. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. For potential or actual medical emergencies, immediately call 911 or your local emergency service. 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. 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 The study included 351 patients with knee OA and meniscus tear. 1 doctor answer 2 doctors weighed in Dr. Jeffrey Sider answered Sports Medicine 41 years experience Depends: If surgery is on the left leg i let some patients drive the next day if they feel ok. Specializes in Orthopedic Reconstructive Surgery. 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. Strength. Easy to talk to and will answer any questions of your care. You'll begin a graduated rehabilitation protocol. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. 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. 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. You will feel tired for several days. There goes my knee again.. 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. Country. 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. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. While there are a small number of patients who do have their meniscus root re-tear, this has been nowhere near as common as the other sources noted above. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. 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. 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. 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. Is this a tear? Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. How long did you have to avoid driving after meniscus surgery? There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. 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. 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. 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. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? They might have a follow up visit or two but its really physical therapy that suppose take over at that point in physical therapy just has you for two to three months and once theyre done with you same thing once youre back to walking and bending your knee all the way and straightening out your knee all the way. (it is still a bit swollen). Great shoulder doc. It is shaped like a C and it serves to cushion and stabilize the knee. 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 ~. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. 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. Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. He spent a great amount of time explaining everything to me in a way that I understood everything. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. More diffuse pain over the inside of the knee which becomes progressive over time can be particular ominous because this may mean that the cartilage is wearing out fast or that one has an insufficiency fracture or spontaneous osteonecrosis of the knee, occurring due to the fact that the meniscus is such an important shock absorber. Can you tear your meniscus again after a surgery and if you do how can you tell? Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. Two days after my surgery, Diego took me to my first PT session. Few tears will become. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. One of the main portions of the system is a guide that can be placed inside the joint that fits around the tibial eminences and allows the surgeon to place the tip of the guide right at the area that has been decorticated of bone, where one wants to perform the root repair tunnel. The next day, my left knee blew up to the size of a grapefruit. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. It can also occur while bending the knee deeply. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . 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. 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.
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driving after meniscus root repair