GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! Thank you Dr. Burnham and Jerrica for everything! Most patients with meniscal root tears will ultimately need surgical fixation of the root. 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. Specializes in Orthopedic Reconstructive Surgery. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. 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 was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. <> One should assess the range of motion at that point in time that can be performed in a safe zone to make sure that the physical therapist does not flex them harder in this time frame. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. In addition, the design of the meniscus is such that the full pressure of weight bearing activities is transmitted through the root of the meniscus, meaning that it is constantly pulling and stretching the tear with every step. The knee buckled and I thought, Shit. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . 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. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. I never met a doctor and his team that showed some much compassion about their patient. short distances based on their motion and If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. I went to Dr. Burnham for issues I was having with my shoulders. One of the most common is in patients who may have some underlying arthritis and the arthritis is causing the pain or the arthritis has progressed further after the meniscus root repair. The posterior roots are the most important as this is where a root tear occurs most commonly. But youre also not alone. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. You'll likely regain your previous muscle strength in the leg by. Dr. Burnham and his remarkable staff have been a godsend for our son. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. Stated to me , in detail, what to expect and how long my recovery will take. It is vital that meniscus repair patients do not squat for at least four months after the repair. We are so grateful and thankful. My repair will be later this week on my right leg. 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 best surgeon is Baton Rouge that actually care about his patients!!! questions after your surgery, during business hours call 763-302-2231. 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. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. Contact Dr. Nwachukwus team today! I finally decided to make an appointment with a knee specialist. My experience with Dr. Burnham and his staff was exceptional. 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. Dr. Burnham has an awesome bedside manner. Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. 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. Other non-medical modalities may help, such as using ice and elevating the leg. The incisions leave scars that usually fade in time. 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. 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. A written consent will be obtained from you after the surgical procedure has been explained in detail. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. And then they lose motion. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . 5 stars! To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. Meniscal root avulsions are a challenging injury causing meniscal extrusion and loss of hoop stress distribution, which can lead to the development of knee arthritis.1 Securing the meniscus in a small bone socket has proven to be an effective means to restore hoop stresses and improve outcomes.2 The FlipCutter II reamer and meniscal root marking hook allow for a minimally invasive . Repetitive motions, overuse, and muscular imbalances ar twitter.com/i/web/status/1, Digging Deeper into the Data: Is Suture Bridge Repair + #PRP really the best technique for #rotatorcuffrepair? twitter.com/i/web/status/1, Wild Life of the Last #BlackJockey to Rule the #KentuckyDerby A meniscus root tear usually will not heal on its own. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. The goal of a meniscus root tear repair is to locate the torn root and tack it back down to the bone using strong sutures. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. 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. This specific type of tear makes up 90% of all meniscal root tears. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . I was hit by a car on my bicycle near Horsetooth Reservoir in CO. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . Untreated meniscus tears can increase in size and lead to complications, such as arthritis. Therefore, we found that non-anatomic meniscus root tear repairs were not successful. He was outstanding. I got rid of the box for squats the end of July. importance of the meniscus root has become more apparent. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. I am now adding 10 pounds a week to the bar for squats. W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. Nothing. This allows the meniscus to heal back to the bone. The general published success rate for a meniscus root repair is between 80% and 85%. The recovery time for meniscus surgery depends on the type of surgery you had. 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. 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. very elderly patients). He provided a thorough explanation without wasting time. Strength. You may need surgery to restore full knee function. 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 . Kyle D. Morgenstern, MD . I would recommend his service to any recreational athlete. He has a great rapport with teenagers. To accomplish this goal, Dr. Nwachukwu drills a small hole from the outside of the tibia (shin bone) into the knee joint next to the natural attachment of the meniscus root. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . There was absolutely no knee pain. I dont remember how or when I tore my meniscus. It hurt like hell. The meniscus root is where the meniscus attaches to bone. I hung on to this MRI referral for a good month or so, because the knee was starting to feel better, and I was still able to train and attend my BJJ classes. 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. What was going to help my knee? General anesthesia and a nerve block. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? 2 0 obj 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. Had a meniscus root repair yesterday and the surgery was successful. 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 . I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. 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. (it is still a bit swollen). Phase I of Rehab: Surgery until 8 weeks. This step involves making a surgical incision or extending a previous surgical incision (such as with an ACL reconstruction) and ensuring that one is dissected down directly to bone. Never disregard or delay professional medical advice in person because of anything on HealthTap. 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. The aftercare and recovery require postoperative protection to allow healing. 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. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. I have no issues taking the stairs, just a little knee discomfort here and there. When these are torn, the loading of the joint is equivalent to having no meniscus on the affected side. 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. 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. Ibuprofen (Advil, Motrin) Naproxen (Aleve) Healing kind of goes fast the beginning and then it tapers off. Surgical repair can successfully allow the meniscus to heal. In determining if one can have a revision root repair, one needs to determine the cause of the failure as well as the amount of underlying arthritis. I would highly recommend him. A meniscus root tear can occur due to a traumatic event or degeneration. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. Wednesday: 8:00 am 5:00 pm % There are many factors that go into this, including a patients weight, with overweight patients putting more stress on the meniscus root tear, ones alignment, where one being bowlegged with a medial meniscus root repair putting extra stress on the repair, and also the amount of underlying arthritis present prior to the root repair. 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. Highlights from the StartingStrength Community. 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. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. No, I didnt say pain free, or I didnt say get back to normal, just strong enough to get back to standing and walking because nobody wants to be in a wheelchair or not be able to get to the bathroom in time because of your knee not working right or being very painful. And thats all good if youre going to end up having the surgery. 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 ~. 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. 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. <>>> Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . The length of time until patients are able to return to driving varies . I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. 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 Dr. Burnham made sure I knew what was happening and what could happen. And this channel is dedicated to helping people stay healthy, active and mobile. United States. Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone).