He provided a thorough explanation without wasting time. Dr Burnhams bedside manner was exceptional. I press and bench with no modifications. Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. This is done to protect the repair and let the body heal it. Timeline: 1 week to 5 weeks after Surgery. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. Does having a cortisone shot help a meniscus tear or is surgery the only option? Hands down would recommend him!! 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. This happens way more often than I like to admit. Figure 5:: Cortical fixation of transtibial meniscal root repair. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. However, if the meniscus re-tore or is placed into a non-anatomic position and ones cartilage surfaces are still fairly intact, an attempt at a revision repair should be made. Dr Burnham is so personable. 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. Are you an athlete who participates in sports that involve running and jumping? I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. This can occur in up to 20% of patients, even in the best of circumstances. I have been walking and training normally for the past four and a half months. Thus, when one does sustain a lateral meniscus root tear with an ACL tear, consideration should be given to having a concurrent lateral meniscus root repair so the ACL graft does not stretch out. 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. His MA Michelle was very professional and kind. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. The system also involves a drill with a cannula whereby one can drill through the tibial guide, see the drill bit come out inside the knee, and then pull the drill bit out and leave the cannula in place. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. 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. We love you! I went to Dr. Burnham for issues I was having with my shoulders. 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. I can run, bike, & climb mountains. 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. 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. We have published and validated our results in the peer-reviewed literature, which was at the time the largest series of meniscus root repairs reported. Meniscus root repair is a surgery performed to repair a torn meniscus root. questions after your surgery, during business hours call 763-302-2231. Video chat with a U.S. board-certified doctor 24/7 in a minute. . 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. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. Then I trained. What was going to help my knee? A meniscus can become damaged due to sudden trauma. They walked me through the process from beginning to end. Full recovery usually takes 6 months but can take up to 1 year. Thank you for choosing Dr. LaPrade as your healthcare provider. And now theyre kind of back to the way they were before the surgery. Strength. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. These radial root tears are equivalent to a meniscus root tear. Most importantly, I have not missed a single coaching or training session since my surgery. 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. I wont ever go anywhere else. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? 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. Fortunately, this is usually done arthroscopically and with good results. A lateral meniscus root tear involves a tear of the meniscus either at or close to the root attachment in the back part of the lateral meniscus. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . Rehabilitation begins within a week of surgery. You will feel tired for several days. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. The meniscus root is where the meniscus attaches to bone. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. As a result, two weeks after surgery I was able to start driving my car, which is a manual. Appreciate the attention and time spent during office visits. And cartilage is one of the slowest healing tissues in the body. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. 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. The study included 351 patients with knee OA and meniscus tear. I would recommend his services to anyone. importance of the meniscus root has become more apparent. while avoiding unnecessary surgery, injections, and medications. It can be very difficult to interpret an MRI after a meniscus root repair. And people are often disappointed to find out that as they begin to get back to normal, as theyve been told that they probably could and should they start to get swelling in the knee, they start to get a pain, of course. You can schedule an office consultation with Dr. LaPrade. The mini First-Pass device allows placement of either a suture or an UltraTape through the substance of the meniscus, capturing the end of the stitch as it is placed through the meniscus and then it can be pulled out of the joint. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. They are connected to your tibia by meniscal roots. 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. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. Most patients will also have some numbness around the surgical incision, but this is not a true complication and is anticipated with any type of surgical incision. Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4 weeks postop. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. 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. He has repaired both of my shoulders and he is awesome to the max. 515 Ray C. Hunt Drive, Suite 1100, Charlottesville, VA 22903 Phone: 434-243-7778 Fax: 434-243-5075 Meniscal Root Repair Post-operative Rehabilitation Protocol. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? 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. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. 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. Instead of wall slides, I opted for high box squats. There are 2 main variants of the transtibial root repair technique. 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. Untreated meniscus tears can increase in size and lead to complications, such as arthritis. And most likely, a meniscus tear.. Definition/Description. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. You'll begin a graduated rehabilitation protocol. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. 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. Ibuprofen (Advil, Motrin) Naproxen (Aleve) Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 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. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. This is because a lack of meniscus attachment at the root causes extra stress to be placed on an ACL graft and it can also result in the patient having more instability, both with anterior tibial translation, and with twisting and turning activities during the pivot shift, when there is a concurrent lateral meniscus root tear. It is vital that meniscus repair patients do not squat for at least four months after the repair. 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. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? Dr Jeremy Burnham has a great way of interacting with his patients. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. I have no issues taking the stairs, just a little knee discomfort here and there. There goes my knee again.. Very thorough, knowledgeable and courteous. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. I finally decided to make an appointment with a knee specialist. I walked around the gym with the crutches, and without the crutches. It helps to be strong, my PT remarked. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. So that means youre good to go after two to three months. Why would I? Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. Dr. Burnham was very helpful for my injury! This results in premature arthritis and cartilage damage in the knee. Then, in January of 2018, while warming up in class one morning, a sharp, nauseating pain shot through my left knee, which made me start limping. Therefore, we strongly advocate using a button to fix the meniscus sutures or tape on the tibia to minimize the chance of loosening over time. I did a few jungle gym rows, and finished with planks. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. stream In determining if one can have a revision root repair, one needs to determine the cause of the failure as well as the amount of underlying arthritis. I was going to rehab myself, and keep training as normally as I could. This is important because these repairs are still quite tenuous with current technology, so it is important to try to put the meniscus back into a position where there would not be a lot of tension on the repair with knee range of motion. It takes longer for a meniscus repair to heal than a meniscectomy. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change.