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. 3 0 obj 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. But now I know more about the body, about rehab, and about what being stronger really means. You may need surgery to restore full knee function. 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. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. After you have surgery to repair a meniscus tear, you may need to build up your strength in the muscles of your leg that support your knee. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. Meniscus Post Surgery Rehabilitation Dr Garcia demonstrates his new meniscal extrusion technique - YouTube (it is still a bit swollen). Meniscal Repair. It was glorious. Most patients with meniscal root tears will ultimately need surgical fixation of the root. I have now biked five to six days each week since my surgery. 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. The length of time until patients are able to return to driving varies . Healing kind of goes fast the beginning and then it tapers off. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. Does having a cortisone shot help a meniscus tear or is surgery the only option? Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. Great shoulder doc. questions after your surgery, during business hours call 763-302-2231. Will Walking on a Torn Meniscus Make It Worse? Injury Care - Healthline Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. When a torn fragment is floating in the joint, patients will feel a sudden, sha twitter.com/i/web/status/1, According to an injury study done in 2021, #Pickleball has been deemed safer than #tennis and better for individual twitter.com/i/web/status/1, Cysts Acetabular Paralabral and Subchondral, ACL Anterior Cruciate Ligament Injury of the Knee, Patellofemoral Pain Syndrome Runners Knee, PVNS of the Knee Pigmented Villonodular Synovitis, Osteochondral Allograft Transplantation Surgery (OATS), Patellofemoral Arthroscopy Runners Knee Treatment, Stabilization for Instability-Arthroscopic, Subacromial Decompression for Impingement, How to prevent common skiing and snowboarding injuries | Ski Injury Doctor Manhattan, BICMD Co-Founder and Co-CEO Announces Expansion of Services, Patients are partial weight bearing for the first 4 weeks and then during weeks 4-6 are progressed to full weight-bearing. He listens and address every concern with appropriate solutions. 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. (Please keep reading below for more information on this treatment.). Meniscus repair rehab protocol. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. Amazing Doctor and wonderful staff!! If I could give more than 5 stars, I would. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. I had a traumatic knee injury that he performed surgery on. short distances based on their motion and Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. There are 2 main variants of the transtibial root repair technique. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. Life happens and our bodies will sometimes let us down. Created for people with ongoing healthcare needs but benefits everyone. These radial root tears are equivalent to a meniscus root tear. Meniscus repair is usually done with arthroscopic surgery. 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. Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. Meniscal Root Repair | Meniscal Root Injury |Orthopedic Knee Surgeon I can run, bike, & climb mountains. Dr. Burnham performed my hip pin surgery and it all went extremely well. And then after the surgery, the focus is doing physical therapy, typically if he gets sent there, and youre going to lose some motion in the surgery so your knee wont be able to bend or straighten all the way. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. The meniscus is a very important piece of cartilage in the knee. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. Meniscal Root Repair | Knee Specialist | Minnesota And this channel is dedicated to helping people stay healthy, active and mobile. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Torn Meniscus | Meniscus Tear Treatment Options | Duke Health Definition/Description. 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. amount of, supply and beyond the age of 15 has limited healing without surgery. 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. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. They explain things very well. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . They are connected to your tibia by meniscal roots. And theres things that you can do, which Ill allude to here in the middle. 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. My surgery was at 8:30am Wednesday, February 20. I rate him 5stars. (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. When Is Driving Safe After Rotator Cuff Repair? 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. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. The study, " Patients Who Undergo Rotator Cuff Repair Can Safely Return to Driving at 2 Weeks Postoperatively ," was published online on July 21, 2022 in the Journal of Bone & Joint Surgery. This technically challenging procedure should only be done by an orthopedic knee expert like Dr. Nwachukwu who has had extensive experience in performing the meniscal root tear repair correctly. Each horn is anchored to the bone at the meniscus root (anterior and posterior). There are some isolated reports of using suture anchors to repair a meniscus root repair, but this area of the knee is very difficult to access and the suture anchors can leave large knots which could subsequently interfere with the cartilage surfaces in the knee. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. This happens way more often than I like to admit. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. endobj 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. Many tears have better outcomes if they are treated early. Patients \50 years had outcomes similar to those of patients !50 years, as did . 2700 Vikings Circle My name is Dr. David Middaugh. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. In January of this year, I finally decided to go back to my doctor to get that MRI. I press and bench with no modifications. It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. while avoiding unnecessary surgery, injections, and medications. 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. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. The biggest mistake that people make after having a meniscus surgery is theyre doing too much way too soon. If you had a knee surgery if youve been seen physical therapy or any other health care professionals and theyre telling you youll be fine in three months back to normal youll be dancing youll be exercising youll be playing with the grandkids again just smile and remember this video. You can schedule an office consultation with Dr. LaPrade. He is walking without a limb and is on schedule with his progress. Dr. Burnham was very thorough with his examination and diagnosis. Dr Burnham is so personable. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. Does a extruded medial meniscus towards the posterior root need surgery? Two weeks today I had meniscus root repair. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone). Meniscus Tear Surgery Recovery Time: When Can I Get Back to Work? Dr Burnhams bedside manner was exceptional. 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 Medial Meniscus Posterior Root Repair Using a Transtibial Technique It can also occur while bending the knee deeply. I kept training, modifying my squatting as needed until I could get back to proper depth. The most common root repair technique is called a transtibial technique. Heel lift in opposite shoe to normalize gait. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. And Im a specialist physical therapist El Paso manual physical therapy. 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. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. For potential or actual medical emergencies, immediately call 911 or your local emergency service. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. I finally decided to make an appointment with a knee specialist. I got a lift home, and returned to the gym later that evening for more coaching. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). A meniscus root tear occurs when one or both of these roots tear away from the bone. Meniscus Root Tear | Orthopedic Knee Specialist | Vail, Aspen, Denver % Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. But youre also not alone. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. With an injury like this you want the best, and Dr. Burnham is the best. 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. But youve got to figure out a way to get your butt muscles stronger if youre looking for a more comprehensive plan for making your knee better and getting your glutes stronger we also have a program called the 28 day knee health and wellness boost program you can also find that in the link and as a link in the description below. I asked when I could start driving, and he said when I was off my pain medication. What Causes Knee Pain 1 Year After Meniscus Surgery? The meniscus is a cushion of the knee joint. Meniscus Root Repair - Joint Replacement Patient Forum He has a great rapport with teenagers. Protect repair Minimize pain Minimize swelling In some severe cases, they cant fully extend their knee out or bend their knee all the way. Previous attempts to make it better provided only temporary relief. Knows his stuff. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Meniscus Root Tear Repair | Orthopedic Knee Surgeon | Manhattan, New My daughter journey was very trying and hard but we made it through with all of their help. I highly recommend him. 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. endobj I could no longer deadlift from the floor, and was having trouble squatting below parallel. He diagnosed the problem quickly and accurately. I also started boxing sessions once a week with one of my coaches as I am not allowed to start back to BJJ until September. The Biggest Mistake People Make After Knee Meniscus Surgery Types of root tears: 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. The incisions leave scars that usually fade in time. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. I did a few jungle gym rows, and finished with planks. 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. Dr. Burnham and his remarkable staff have been a godsend for our son. 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. 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 During our biomechanical testing, we found that if we tied the sutures directly over bone, with cyclic loading, the sutures would cut into the bone and the repair would become loose over time. In some cases, its important that you take away from this video today that it takes six to 12 months to heal from a meniscus surgery. And now theyre kind of back to the way they were before the surgery. This is because the signs of arthritis are usually pain and swelling with activities. There goes my knee again.. Are you an athlete who participates in sports that involve running and jumping? Thank you for choosing Dr. LaPrade as your healthcare provider. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. Really a national leader in sports medicine! Meniscus Repair. 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. But if we are stronger, we are harder to break, and we most certainly recover faster and better. This hoop stress is resisted by fibers that run circumferentially through the meniscus. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. I left my visit feeling very comfortable with where I was and what needed to happen next. 1 doctor answer 2 doctors weighed in Dr. Jeffrey Sider answered Sports Medicine 41 years experience Depends: If surgery is on the left leg i let some patients drive the next day if they feel ok. Robert LaPrade, MD, PhD In addition, if the medial meniscus is involved, active 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. Therefore, we then looked at surgical techniques and due to the fact that we had multiple second look arthroscopies after bone grafting for ACL reconstructions with meniscus root tears, that the 1-tunnel technique had more of a spot welding healing of the meniscus to bone whereas the 2-tunnel meniscus root repair technique had a much better healing surface of the meniscus to bone. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Tuesday: 8:00 am 5:00 pm And Im a specialist physical therapist El Paso manual physical therapy. On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. Monday: 8:00 am 5:00 pm Many meniscus tears can be treated successfully without surgery. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. Country. 1 0 obj Once my doctor started the procedure, it was obvious that this would not be a simple surgery. PDF Meniscal Root Repair Post-operative Orders 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. 2018;47:762. Figure 5:: Cortical fixation of transtibial meniscal root repair. We are so grateful and thankful. Nothing. I also found that there were patients being referred to me who had meniscus root repairs that were done well, but the meniscus was not pulled back in the joint and these patients continued to have pain. 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. United States. 1) You must be off narcotic medications for a . Therefore, our surgical technique, using specific guides to avoid the eminences to ensure that one can place the guide exactly where one wants to have a cannula come out in the joint, using cannulas to allow for placement of passing sutures quickly and efficiently, having 2 separate cannulas with 2 separate tunnels for the meniscus repair, releasing the meniscus thoroughly to pull it back in the joint so it functions most effectively, and then having self-capture suture devices, which can place suture or tape into the meniscus substance, shuttle them down the tibia, and then tie them over a metal button on the tibia.

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