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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. This is because the signs of arthritis are usually pain and swelling with activities. xYIoH8(Jr@fI)/_U}|xW&JDIraqm Other sources of pain can include scarring within the joint that occurs as a normal part of a surgical procedure, or pain from other pathology and joint, such as arthritis under the kneecap. My wait time for office visits has always been less than 10 minutes. Meniscus root repair rehab will usually start 1-2 days after surgery. Your doctor put a lighted tubecalled an arthroscope or scopeand other surgical tools through small cuts (incisions) in your knee. Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. I dont remember how or when I tore my meniscus. (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. with time whether there is healing or not. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. 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. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. But if we are stronger, we are harder to break, and we most certainly recover faster and better. 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 decided right then and there I would not get the MRI. What to do if I have a radial meniscus tear, what's the chance of it fully healing with surgery? I was going to rehab myself, and keep training as normally as I could. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. If I had not spent the last several years of my life squatting, benching, pressing and deadlifting, I would not have had the strength to continue to be as active as I was after my surgery, and I most certainly would not have known how to rehab my knee on my own. <> Dr. Burnham and his staff were/are amazing. 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. Walk with crutches. 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. Procedure for Meniscus Root Repair. Timeline for Meniscus Repair Recovery: It will take around 4-6 weeks before you can walk, drive, and otherwise move normally as you would prior to your injury. short distances based on their motion and The why answer is that the meniscus root is an important stabilizer to the meniscus to ensure that it can function as effectively as possible as a shock absorber. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. Figure 5:: Cortical fixation of transtibial meniscal root repair. 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. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. And this channel is dedicated to helping people stay healthy, active and mobile. Strength. 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 am so glad I did! Meniscus root repair is a surgery performed to repair a torn meniscus root. The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. EDINA- CROSSTOWN OFFICE In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. Most of these types of injuries, that are symptomatic, require surgery. After hours 763-520-7870 Address Maple Grove 9630 Grove Circle N., Suite 200 Maple Grove, MN 55369 Minnetonka 15450 Highway 7, Suite 100 Minnetonka, MN 55345 Robbinsdale 3366 Oakdale Ave. N Suite 103 Robbinsdale, MN 55422 Knee Meniscus Root . Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. Phase I of Rehab: Surgery until 8 weeks. But the next day, I woke up and literally ran down my stairs. And Im a specialist physical therapist El Paso manual physical therapy. Dr. Burnham was very thorough with his examination and diagnosis. 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. 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. Each horn is anchored to the bone at the meniscus root (anterior and posterior). 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 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. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? At the beginning of April, I was dancing at a friends wedding when I suddenly heard and felt a loud pop in my left knee. When you put weight on your leg, it is the meniscal roots that transfer the axial loading forces of the knee into hoop stress in the meniscus. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Your care after surgery may involve: Crutches to take stress off the knee as it heals. Identifying and properly treating meniscus tears (with or without surgery) will lead to the most rapid reduction in your symptoms and is crucial to optimize the long term health of your knee. 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 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. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. 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. Non-anatomic root repairs do not restore normal joint biomechanics . Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. I recommend him, as well as his staff, to anyone requiring such services. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. If scar tissue is present, Dr. Nwachukwu will clean up the area so the knee is allowed to move through its entire range of motion. My surgery was at 8:30am Wednesday, February 20. 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. Then I trained. Further study into meniscus root tears and radial root tears is ongoing by our research laboratory to try to improve the treatment of these complex problems. This can occur with turning, twisting, or pivoting activities or sports. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. Meniscus root repair surgery recovery Most patients can return to full activity 4-6 months after a meniscus root repair. But its just not common knowledge to take six to 12 months to heal after a meniscus surgery. Dr Jeremy Burnham has a great way of interacting with his patients. 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. I limped from the wedding venue to the car, and then from the car to my house. This can occur in up to 20% of patients, even in the best of circumstances. Meniscus root tears usually occur in patients with deep flexion such as skiers, or home gardeners, plumbers, or carpet layers or people doing similar activities. But now I know more about the body, about rehab, and about what being stronger really means. 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. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. Dr. Burnham is amazing. I had a traumatic knee injury that he performed surgery on. Two weeks. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Driving after meniscus root repair depends on which knee it is. 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? You will feel tired for several days. 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. 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. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. I never met a doctor and his team that showed some much compassion about their patient. endobj 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. 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. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . 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. 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. Therefore, it is strongly recommended to proceed with a meniscus root repair whenever possible, with patients up to the age of 70 being reported as having excellent return of function. Oct 24, 2020. Really a national leader in sports medicine! A written consent will be obtained from you after the surgical procedure has been explained in detail. repair to heal. 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. Heel lift in opposite shoe to normalize gait. You may need surgery to restore full knee function. If so, you may be at risk of tearing the root of your meniscus. 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 ~. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. I wont ever go anywhere else. The meniscus is a piece of cartilage in the knee, often injured in sports. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. Please try again. In cases the patients undergo meniscus repair or ligament reconstruction, they are given a brace to support the knee in full extension. 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. 2700 Vikings Circle This is probably due to many factors, including the chronicity of the tear, the quality of the tissue, if the meniscus was released from scar tissue and pulled back in the joint, ones age, ones weight, and ones alignment. 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. When I returned home around 1pm that day, I sat in my living room for a bit, emailing and texting people to let them know I was alive and well. 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. 3 0 obj When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. 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. I continued to lower the box for squats, and started to add weight. I really like and appreciate the time and effort he commits to research. 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. Very thorough, knowledgeable and courteous. They are connected to your tibia by meniscal roots. You'll likely regain your previous muscle strength in the leg by. With an injury like this you want the best, and Dr. Burnham is the best. Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. That night, I drove myself to the gym. Meniscus root repair surgeon, Doctor Benedict Nwachukwu provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, New York City, NY who need meniscus root repair surgery. Theyre kind of done with you too but what if you want to go play with the grandkids do you want to kneel what do you want to exercise youve got to set your expectations to still take it easy still rehab or strengthen the right muscles or do the right kind of treatment for yourself so that you can continue to heal. He has a great rapport with teenagers. The best surgeon is Baton Rouge that actually care about his patients!!! Really cares for his patients! Super knowledgeable. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. 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. Dr. Burnham performed my hip pin surgery and it all went extremely well. 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. That means that the remaining meniscus is smaller, but still taking the same pressure. 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. I did a few jungle gym rows, and finished with planks. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. I can run, bike, & climb mountains. 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. Regular assessment of gait to avoid compensatory patterns. #12. It is our goal to provide the highest level of care and service to our patients. 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. 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. There are two menisci in the knee, medial and lateral. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Definition/Description. Your subscription could not be saved. This technique is fast and effective. The next steps involve placing self-capture sutures into the end of the meniscus root and then drilling cannulas into the area that was decorticated such that the sutures placed into the meniscus can be shuttled down the cannulas and then tied over the tibia. I am now adding 10 pounds a week to the bar for squats. 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. 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. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. No swelling. 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. Being stronger is always better than being weak. My pain was gone. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. You should also be able use your leg for driving after one to two weeks, as long as you're not taking opiate pain medication. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. Meniscal Ramp Lesions. You'll begin a graduated rehabilitation protocol. 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. The posterior roots are the most important as this is where a root tear occurs most commonly. His extensive schooling, research, and commitment to his craft shined through at every turn as he evaluated my injury, presented all my options (clearly explaining non-surgical options and expected outcomes), and helped me plan my course of treatment and recovery. Thank you. Meniscus repair recovery While everyone's recovery is different, here's what you can typically expect with a repair surgery: You may be on crutches for four to six weeks. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. So that means youre good to go after two to three months. And get the pain under control and recover normally the way that you should have once you start doing the right things.