I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. The procedure can be a complete meniscectomy where the meniscus and the . A meniscus root tear usually will not heal on its own. 3 0 obj A torn meniscus can result in either sudden or gradual onset of pain. Therefore, a lateral meniscus root repair can be an essential portion of a surgery to address the secondary restrains for a concurrent ACL reconstruction procedure. Most meniscus root tears require surgery. 4 0 obj 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. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. 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. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. What made my recovery so fast? And cartilage is one of the slowest healing tissues in the body. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. He listens and address every concern with appropriate solutions. It helps to be strong, my PT remarked. El Paso, Texas 79903. 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. A surgical guide can then be placed in a drill tip where the cannula around it is placed into the area of the decorticated bone. Tuesday: 8:00 am 5:00 pm 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 . A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. And get the pain under control and recover normally the way that you should have once you start doing the right things. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. It was tough, and it hurt like hell, but I took it slowly. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Sometimes the meniscus damage occurs more gradually as part of degeneration. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. importance of the meniscus root has become more apparent. My name is Dr. David Middaugh. A week later, I got my MRI results and I was told that this was going to be a very long recovery, but I had other plans. <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 12 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. I never met a doctor and his team that showed some much compassion about their patient. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. 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. <> The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. But the next day, I woke up and literally ran down my stairs. 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. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. But theres still healing to be done and that 20% is really critical. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. while avoiding unnecessary surgery, injections, and medications. Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. The feeling that your knee is giving way, locking, or catching when you bend it. If so, you may be at risk of tearing the root of your meniscus. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. If not even worse. And the good news is that it can be helped without another surgery. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. The most important aspect to assess when one is looking at a root repair is to ensure that ones cartilage surfaces are still fairly normal. 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. Dr. Burnham & his staff are very personable & caring. 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. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. 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. 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. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. Oct 24, 2020. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. 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. The best surgeon is Baton Rouge that actually care about his patients!!! Doctors typically provide answers within 24 hours. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Meniscus Repair. Request Case Review or Office Consultation, Lateral Patellotibial Ligament Reconstruction, Anatomic Analysis of the Posterior Root Attachments of the Menisci, Posterior Root Avulsion Fracture of the Medial Meniscus, Not Your Fathers (or Mothers) Meniscus Surgery, Anterior Intermeniscal Ligament of the Knee An Anatomical Study, Popliteomeniscal Fascial Tears Causing Symptomatic Lateral Compartment Knee Pain, Prospective Outcomes Study of Meniscal Allograft Transplantation. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. The Steadman Clinic - Edwards, CO Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& [email protected]:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. He is walking without a limb and is on schedule with his progress. 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. I was worried for my future with my legs letting me walk but she put me at ease letting me know she will do everything in her power to fix me or send me to whatever specialist I need to see to make sure I have a good chance walking in my future, and they all truly fantastic doctors. So that means youre good to go after two to three months. A meniscus root tear can occur due to a traumatic event or degeneration. The knee buckled and I thought, Shit. 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. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). Do minor meniscus tears require surgery or can it repair itself? Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Most importantly, I have not missed a single coaching or training session since my surgery. 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. Oftentimes, after having a meniscus surgery, people are told that theyll be fine. The thoughtful, open communication and treatment was everything I could have asked for pre-, during, and now post surgery. Strength is one of the most important aspects of our lives. 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. Your knee will be swollen. I'm taking pain meds regularly to try and ease pain. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. Your subscription could not be saved. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. The meniscus is a very important piece of cartilage in the knee. . Arrange for someone to drive you home as you will not be able to drive yourself after surgery. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. Many patients do not have significant joint line pain like a typical meniscus tear, so having a patient stand up and squat down is often performed during the clinical exam to validate that the patient may have a meniscus root tear. Dr Burnhams bedside manner was exceptional. The torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. I finally decided to make an appointment with a knee specialist. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. 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. 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. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. The knee will be swollen for 2-3 months. 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. 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 particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. This hoop stress is resisted by fibers that run circumferentially through the meniscus. Procedure for Meniscus Root Repair. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. How long after surgery for a meniscus tear will i be able to drive again. Using specific guides to ensure that one can place tunnels in the anatomic position and using self-capture devices, which have been devised to be small enough to not scuff up the cartilage, are some of the best means to perform a transtibial meniscus root repair with self-capture devices. 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. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. Dr. Burnham performed my hip pin surgery and it all went extremely well. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Prior to that, they are recommended to use crutches. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. 2601 E. Yandell Drive, Suite 232 Meniscus root repair is a surgery performed to repair a torn meniscus root. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. 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. One should not look at age as a factor for meniscus root repairs. The second step is to prepare a bony bed where the meniscus repair will be performed. This allows the meniscus to heal back to the bone. I have two good arms, and a good leg. No swelling. Types of root tears: Other non-medical modalities may help, such as using ice and elevating the leg. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. Dr. Burnham and his remarkable staff have been a godsend for our son. I highly recommend him. 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. And this channel is dedicated to helping people stay healthy, active and mobile. 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. I highly recommend Dr Burnham for your orthopedic needs hands down. I decided right then and there I would not get the MRI. The next day, my left knee blew up to the size of a grapefruit. Hence, that remaining meniscus is more and not less likely to tear again. So lets get to it. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . And Im a specialist physical therapist El Paso manual physical therapy. Just its a big deal to take your time and let that cartilage heal at the rate that it heals you generally can go faster than what it heals, And the question that i get often is do i take any supplements glucosamine chondroitin those types of supplements and you know the answer to that is its not going to hurt we the research is kind of mixed on it sometimes it helps sometimes it doesnt help what we know is that it generally doesnt hurt it doesnt make it worse so youre not going to youre not going to make things worse if you decide to take those supplements are generally safe to take but some people report no difference. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. My calf swelled up into my ankles. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . Because this is a frequent question posed on Google, I will try to be modest in answering this. 2700 Vikings Circle Full recovery from meniscus surgery can take anywhere from six weeks to three months. 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. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. It was glorious. This can occur with turning, twisting, or pivoting activities or sports. Definitely a Bakers Cyst, my doctor said when I saw him. It was press/bench day, so I set up for some seated presses and dragged a stool over to prop my left leg up while I benched. We love you! This specific type of tear makes up 90% of all meniscal root tears. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. In radiologic terms, this is called a bony ossicle. The technique for a repair for a bony avulsion, called a type 5 meniscus root tear, is similar to the other techniques other than it should have the bone piece shaved down and cleaned off such that it can be pulled back into the area where it had been avulsed from. Ill def refer friends and family! 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. Their sense of compassion and understanding is more than we have ever experienced. 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 . 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. 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. Both my children have seen Dr. Burnham with great results. I got a lift home, and returned to the gym later that evening for more coaching. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. They moved my knee a bit, and I had decent ROM, better than expected. 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 got rid of the box for squats the end of July. That was day one. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. 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. Meniscal repair may be performed either by open surgery under direct vision or minimally invasively using an arthroscope that can be inserted into the knee through a very small key-hole incision to locate and repair the damaged meniscus. So if thats your feeling youve taken them and it hasnt really made a difference for you dont take them if you feel like to help you out please take them but dont just take the supplements in hopes of that replacing doing the right exercises and having the right expectations youve got to do them both together give us a like if you thought this video was helpful and please drop a comment if you have any questions and i hope that you get better real soon have a wonderful day guys. Also, I had to make numerous visits to the Ochsner Clinic due to my injury and Dr. Burnham's team and the staff at Ochsner were always very professional and courteous. Later that summer, the left knee began to bother meagain. 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. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. The most common complication after a meniscus root repair is a re-tear. Two weeks. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Thank you Dr. Burnham and Jerrica for everything! Please try again. 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. Does having a cortisone shot help a meniscus tear or is surgery the only option? Medial Patellofemoral Ligament (MPFL) Reconstruction . Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. I walked around the gym with the crutches, and without the crutches.
