Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. 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 . Dr. Burnham & his staff are very personable & caring. Types of root tears: I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. 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 Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Thank you Dr. Burnham for being so amazing! Really cares for his patients! 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. Many meniscus tears can be treated successfully without surgery. So if youre sitting at home right now, and you just had your meniscus surgery a month or two ago, and youre thinking, gosh, why arent I much better already. I would have relied strictly on physical therapy. What was going to help my knee? Two days after my surgery, Diego took me to my first PT session. Dr. Burnham is amazing. Very positive experience at Bone and Joint Clinic in Baton Rouge. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. 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. Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4 weeks postop. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. xYIoH8(Jr@fI)/_U}|xW&JDIraqm I would recommend his service to any recreational athlete. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. Ibuprofen (Advil, Motrin) Naproxen (Aleve) As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. 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. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? 181 West Meadow Drive Suite 400 Vail, CO 81657. 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. 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. They can occur in younger patients as a result of high energy trauma, but are more common in patients between 45 and 60 as a result of degeneration of the meniscus with age. There are some isolated reports of using suture anchors to repair a meniscus root repair, but this area of the knee is very difficult to access and the suture anchors can leave large knots which could subsequently interfere with the cartilage surfaces in the knee. The following Tuesday, I saw my doctor. 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. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. 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. Do minor meniscus tears require surgery or can it repair itself? While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. The most common method to fix meniscus root tears is through a tibial bone tunnel. 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. An ACL tear commonly has a pop on the outside of the knee, whereas a patient who has meniscus root tear commonly feels a pop in the back of the knee. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. It was glorious. 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. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. . The study included 351 patients with knee OA and meniscus tear. 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 ~. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. 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. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. In addition, there is no low age for meniscus repairs, with some root repairs being done in patients as young as 6 or 7 years old. They moved my knee a bit, and I had decent ROM, better than expected. Dr. Burnham was very personable and explained my situation in great detail. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? That means that the remaining meniscus is smaller, but still taking the same pressure. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. Sit at home on the couch and watch T.V.? I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. El Paso, Texas 79903. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. The recovery time for meniscus surgery depends on the type of surgery you had. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. Very reassuring, showed me X-rays and explained the healing process very clearly. We currently use UltraTape to do this. Dr. Burnham took his time and answered all my questions with explanations. The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. This is done to protect the repair and let the body heal it. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. 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. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. After sutures are placed arthroscopically into the meniscal attachment, a small diameter tunnel, usually 5 millimeters in size, is reamed to the meniscal root attachment site, the sutures are pulled down the tunnel, and tied over a button on the anterior cortex of the tibia. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. 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. The most common complication after a meniscus root repair is a re-tear. I never met a doctor and his team that showed some much compassion about their patient. The procedure can be a complete meniscectomy where the meniscus and the . The knee will be swollen for 2-3 months. 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. Strength is one of the most important aspects of our lives. For this reason, much research has gone in to meniscus root repairs over the last several years. 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. Contact Dr. Nwachukwus team today! 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. Procedure for Meniscus Root Repair. His staff is very friendly and upbeat, knowledgeable and thorough. This can occur with turning, twisting, or pivoting activities or sports. 2018;47:762. Surgical repair can successfully allow the meniscus to heal. 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. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. I wasnt taking any pain medication either, so I was alert. If so, you may be at risk of tearing the root of your meniscus. 1) You must be off narcotic medications for a . Protect repair Minimize pain Minimize swelling I got a lift home, and returned to the gym later that evening for more coaching. And they can get back to normal in about two or three months after having the surgery. . Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. 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. So its important at the very beginning its appropriate at the very beginning to make sure that all your emotions back and that you can do some simple walking to and from the house even though hurts so that youre not you know having accidents and better so youre not having emergencies happening you need the function of your leg back. Ill def refer friends and family! We had a wonderful experience and I highly recommend him. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. 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. By far the best orthopedic team I have ever met. Most of these types of injuries, that are symptomatic, require surgery. This allows the meniscus to heal back to the bone. Usually, pain is minimal after this type of surgery. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. I have two good arms, and a good leg. Next, we performed biomechanical studies to show the effects of varying sizes of radial meniscus root tears, validating that a meniscus root tear within a centimeter of its attachment site functions as a meniscus root tear and can be treated the same. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. 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. Meniscus Repair. I would highly recommend him. Im telling you right now its going to take six to 12 months just erase that number that they gave you in your head and i wouldnt go argue with them because they may not have all the knowledge and understanding behind it and truth be told surgeons oftentimes you know once they finish their surgery theyre kind of done with you. I press and bench with no modifications. 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. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. Your subscription could not be saved. 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. I chose not to use my crutches anymore. 4. I started Brazilian Jiu-Jitsu about four years ago. 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. 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. Few tears will become. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. If you break down what most healthcare provision professionals tell their patients, it could be an orthopedic surgeon, or even a physical therapist, its telling somebody whos just had a meniscus surgery, theyll say, well, 80% of healing is done in the first two to three months. Oftentimes, after having a meniscus surgery, people are told that theyll be fine. I am so glad I did! Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. He has repaired both of my shoulders and he is awesome to the max. Therefore, the patient should be worked up in a timely fashion when they do have a posterior horn medial meniscus root tear to determine if they are a candidate for a posterior horn medial meniscus transtibial root repair. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. I was adding 10 pounds a week for deadlifts but have now switched to pause deadlifts on Tuesday and add only 5 pounds a week to the heavy deadlift. Oct 24, 2020. You'll likely regain your previous muscle strength in the leg by. The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. stream Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Takes his time with you and doesn't hurry to rush out of the room if you have questions. <>>> Life happens and our bodies will sometimes let us down. 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. 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. Very professional! 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. I continued to lower the box for squats, and started to add weight. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. Being stronger is always better than being weak. 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. 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 the end he offered the best treatment for me.This is the first time in months that I have felt myself. Doctors typically provide answers within 24 hours. Is this normal? By using our website, you consent to our use of cookies. Most importantly, I have not missed a single coaching or training session since my surgery. Definitely recommend. In patients who have open growth plates, consideration may be necessary to either plan to remove the sutures after the meniscus root repair heals or to consider placing the tunnels and suture repair above the growth plate such that is does not cross the growth plate and have a theoretical chance of causing a growth plate arrest. I highly recommend him. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. But if we are stronger, we are harder to break, and we most certainly recover faster and better. Often, when a meniscus root is torn, it will retract in the joint and become stuck in place. You will begin to focus on regaining your ROM and begin more in muscle strengthening.