The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Non-anatomic root repairs do not restore normal joint biomechanics . The most important thing as one gets older is the quality of the cartilage present. Medication may be needed for 2-3 weeks. Thanks to his staff for being so helpful. 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. They walked me through the process from beginning to end. In the early stages of your meniscus tear you can take these conservative and essential treatments which are as follows: Rest Ice every 15 minutes in every 4-6 hours Compression with an ACE wrap or sleeve Elevation of the leg Nonsteroidal anti-inflammatory medications (NSAIDs) for pain. The incisions leave scars that usually fade in time. He answered all my questions satisfactorily and his entire staff were polite and professional. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. For more information on meniscus root tears of the knee and meniscus root repair surgery, please contact the office of Benedict Nwachukwu, MD, orthopedic knee specialist serving Manhattan, New York City and the surrounding New York boroughs. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. Dr. Burnham and his remarkable staff have been a godsend for our son. So that means youre good to go after two to three months. I got a lift home, and returned to the gym later that evening for more coaching. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. 4 0 obj Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. Patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs can expect a variation of the following: Dr. Nwachukwu is extremely knowledgeable about his area of expertise. 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. Robert LaPrade, MD, PhD Video chat with a U.S. board-certified doctor 24/7 in a minute. 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. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. 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. 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. 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. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. Both my children have seen Dr. Burnham with great results. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. What was going to help my knee? We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. I went to Dr. Burnham for issues I was having with my shoulders. My pain was gone. Later that day, I trained. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. I could no longer deadlift from the floor, and was having trouble squatting below parallel. And thats the 80% fact is true that does happen. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. Dr Jeremy Burnham has a great way of interacting with his patients. I can run, bike, & climb mountains. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. The meniscus is a very important piece of cartilage in the knee. It was tough, and it hurt like hell, but I took it slowly. But youre also not alone. Call your doctor or 911 if you think you may have a medical emergency. (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 possible cause for knee pain 1 year after meniscus surgery would be a re-tear of the meniscus. 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. 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. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. The average pain levels after a meniscus root repair fit between a basic knee arthroscopy (minimal pain) and an ACL reconstruction (more severe pain). This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. 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. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. I would recommend his services to anyone. And if we know anything about cartilage, if you want to look this up, it takes about six up to 12 months to fully heal depending on the severity of that injury on the meniscus on that cartilage. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. Easy to talk to and will answer any questions of your care. I wont ever go anywhere else. And I feel my rode to recovery will be wonderful. 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. Specializes in Orthopedic Reconstructive Surgery. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. United States. 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. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. They have poor healing potential, and are extremely important to the stability and cushioning of the knee. Takes his time with you and doesn't hurry to rush out of the room if you have questions. 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. How long did you have to avoid driving after meniscus surgery? (Please keep reading below for more information on this treatment.). 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. I kept training, modifying my squatting as needed until I could get back to proper depth. Regular assessment of gait to avoid compensatory patterns. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. After about five minutes, the wheels were spinning. 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. Thank you Dr. Burnham for being so amazing! Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after 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. But you need to still continue doing a few things to make sure that you get that remaining 20% healed so that you can truly get back to normal so let me give you some practical advice here three things that i want you to take away from this video number one set your expectations. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . What to do if I have a radial meniscus tear, what's the chance of it fully healing with surgery? 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. If one has fairly normal cartilage of that side, the success rate is going to be better than those patients that have mild to moderate chondromalacia (arthritis) of the same compartment as the root repair. Everyone made us feel comfortable, and they were all polite and professional. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. My surgery was at 8:30am Wednesday, February 20. 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. This happens way more often than I like to admit. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. He is walking without a limb and is on schedule with his progress. If the patient has or has developed significant arthritis, which is usually designated at Kellgren-Lawrence grades 3 or 4, it is felt that a revision root repair may not be indicated. My daughter journey was very trying and hard but we made it through with all of their help. Meniscus Repair. stream Please help. A meniscus root tear usually will not heal on its own. Please try again. 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 In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint. Definition/Description. Really cares for his patients! Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. I am a coach, and I have two boys playing sports, the best thing I can say is that my sons will go see Dr. Burnham in the event they are injured, and I will always recommend him to my athletes. Definitely recommend. And they can get back to normal in about two or three months after having the surgery. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. Country. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. The best surgeon is Baton Rouge that actually care about his patients!!! Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. <>>> It has now been demonstrated that the results of meniscectomies are almost the same as not treating the meniscus root tear at all with a large number of patients within 5 years proceeding to needing a total knee arthroplasty. 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. You'll likely regain your previous muscle strength in the leg by. Previous attempts to make it better provided only temporary relief. Dr. Burnham and his staff were/are amazing. Their sense of compassion and understanding is more than we have ever experienced. 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. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. I had a traumatic knee injury that he performed surgery on. Prior to that, they are recommended to use crutches. This is done to protect the repair and let the body heal it. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. 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 During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. 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. This is because the signs of arthritis are usually pain and swelling with activities. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. So happy I found them! Dr. Burnham was very helpful for my injury! I opened my gym shortly after taking up strength training in earnest to help address my back pain, and have been working for the past eight years to help others embrace their true potential and strength. %PDF-1.5 Can you tear your meniscus again after a surgery and if you do how can you tell? A meniscus root tear occurs when one or both of these roots tear away from the bone. In recent years the importance of the meniscus root has become more apparent. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. Highlights from the StartingStrength Community. 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. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? Untreated meniscus tears can increase in size and lead to complications, such as arthritis. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. with time whether there is healing or not. 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. Kyle D. Morgenstern, MD . Hands down would recommend him!! It hurt like hell. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. It has been found that one suture alone for the repair does not work well, so a minimum of 2 sutures is required to maximize meniscal healing. And now theyre kind of back to the way they were before the surgery. But its just not common knowledge to take six to 12 months to heal after a meniscus surgery. And Im a specialist physical therapist El Paso manual physical therapy. 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. We will determine during your consultation whether general or regional anesthesia would be appropriate - either way, no pain will be experienced during the procedure itself. Swelling and stiffness. 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. I am now adding 10 pounds a week to the bar for squats. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. I have two good arms, and a good leg. If it is your right knee, it will be at least a week before you can drive, as it would be risky to have to hit the break too soon after surgery, and you would be a risk to yourself and everyone else on the road. One should not look at age as a factor for meniscus root repairs. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. Currently, there are mini First-Pass devices that curve to the right and the left, which allows increased access to a root tear, especially since most root tears tend to squirt to the back part of the joint and can be more difficult to access with a straight biter. Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4 weeks postop. The length of time until patients are able to return to driving varies . If youre watching this video today, and youre considering having a meniscus surgery for your knee, then youll want to listen closely so that you dont make this mistake after you have your meniscus surgery. In January of this year, I finally decided to go back to my doctor to get that MRI. 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. My name is Dr. David Middaugh. Thanks to Dr. Burnham and his staff. Meniscus root repair surgery recovery Most patients can return to full activity 4-6 months after a meniscus root repair. I started Brazilian Jiu-Jitsu about four years ago. I continued to lower the box for squats, and started to add weight. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. You have two roots per meniscus which include anterior and posterior roots. Other non-medical modalities may help, such as using ice and elevating the leg. After creating two transtibial tunnels, passing sutures through the detached root of the meniscus and down the tibial tunnels, the sutures are tensioned to reduce the root of the meniscus to anatomic position. It can also occur while bending the knee deeply. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. How long after surgery for a meniscus tear will i be able to drive again. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. Do minor meniscus tears require surgery or can it repair itself? I walked around the gym with the crutches, and without the crutches. They are connected to your tibia by meniscal roots. So lets get to it. . 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. 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. 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. I finally decided to make an appointment with a knee specialist. I am so glad I did! importance of the meniscus root has become more apparent. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 The healing phase is long, but he does A+ work. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. He diagnosed the problem quickly and accurately. Sometimes the meniscus damage occurs more gradually as part of degeneration. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Patients often report hearing a pop at the time of injury. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). You can schedule an office consultation with Dr. LaPrade. Dr. Burnham has an awesome bedside manner. 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. (it is still a bit swollen). 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. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. Dr. Robert F. LaPrade operated on my right knee in May of 2010. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. Knows his stuff. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. If one does have quite a bit of arthritis of the same compartment, which we would call Kellgren-Lawrence grades 3 or 4, in most circumstances, other than possibly in very young patients, a root repair would generally not be indicated. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . My daughter recovered fully from a total knee reconstruction and now she able to return to sports. Your care after surgery may involve: Crutches to take stress off the knee as it heals. 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. HSS Sports Medicine Institute West Side The procedure can be a complete meniscectomy where the meniscus and the . Never disregard or delay professional medical advice in person because of anything on HealthTap. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? Each week my leg brace is put to a different degree so I learn to bend my knee again. And this channel is dedicated to helping people stay healthy, active and mobile. while avoiding unnecessary surgery, injections, and medications. Many tears have better outcomes if they are treated early. very elderly patients). 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. I was very pleased seeing Dr. Burnham, however I was not pleased to learn I was expected to pay an additional co- pay within the same week to receive the results of my MRI. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. 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. It was glorious. By far the best orthopedic team I have ever met. 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. Dr. Burnham took his time and answered all my questions with explanations. The general published success rate for a meniscus root repair is between 80% and 85%. So getting swelling, or if its been a year since you had your meniscus surgery, and youre better overall, but youre still getting some swelling and pain, then its normal.
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