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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. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? Some patients may experience catching, clicking, or locking of their knee. 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. My surgery was at 8:30am Wednesday, February 20. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. 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. 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. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. But if we are stronger, we are harder to break, and we most certainly recover faster and better. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. United States. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. The procedure can be a complete meniscectomy where the meniscus and the . 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. The recovery time for meniscus surgery depends on the type of surgery you had. The most common root repair technique is called a transtibial technique. You will feel tired for several days. 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. Your knee will be swollen. There goes my knee again.. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. When I woke up I was in significant pain but the nurses had it under control by the time I left. 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. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. 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. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. They walked me through the process from beginning to end. Browse archives. Most patients with meniscal root tears will ultimately need surgical fixation of the root. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! 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. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Prior to that, they are recommended to use crutches. 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. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. #12. My 14 year old son originally went in to see Dr. Burnham very scared (he hadn't had an injury before) and he was instantly made to feel at ease. 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. Very positive experience at Bone and Joint Clinic in Baton Rouge. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Strength is one of the most important aspects of our lives. There can be many factors which can potentially cause pain after a meniscus root repair. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. I recommend him, as well as his staff, to anyone requiring such services. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. And its really concerning and very disappointing for somebody whos gone through the knee surgery. In patients who have open growth plates, consideration may be necessary to either plan to remove the sutures after the meniscus root repair heals or to consider placing the tunnels and suture repair above the growth plate such that is does not cross the growth plate and have a theoretical chance of causing a growth plate arrest. It can also occur while bending the knee deeply. Medial Patellofemoral Ligament (MPFL) Reconstruction . 1) You must be off narcotic medications for a . Most importantly, I have not missed a single coaching or training session since my surgery. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. You may need to leave a message. 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. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. And they can get back to normal in about two or three months after having the surgery. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. 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. Country. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. 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. 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. 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. A meniscus that still has extrusion present also does not function as well over the long term. I would recommend his service to any recreational athlete. If patients put weight on the knee immediately after the repair, the forces on . And Im a specialist physical therapist El Paso manual physical therapy. 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. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . Doctors typically provide answers within 24 hours. 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. Patients \50 years had outcomes similar to those of patients !50 years, as did . 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. They can occur in younger patients as a result of high energy trauma, but are more common in patients between 45 and 60 as a result of degeneration of the meniscus with age. These UltraTape or sutures can then ultimately be shuttled down the cannulas and then tied over a metal button on the front part of the tibia. 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. Kyle D. Morgenstern, MD . If I could give more than 5 stars, I would. 2 0 obj I press and bench with no modifications. What could you eat or do for a meniscus tear to heal faster after surgery? dressing in 48 hrs and may let them drive 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. The knee buckled and I thought, Shit. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Contact Dr. Nwachukwus team today! The average pain levels after a meniscus root repair fit between a basic knee arthroscopy (minimal pain) and an ACL reconstruction (more severe pain). 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 cases the patients undergo meniscus repair or ligament reconstruction, they are given a brace to support the knee in full extension. A torn meniscus can result in either sudden or gradual onset of pain. 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. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. 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. It is our goal to provide the highest level of care and service to our patients. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. Why would I? In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. 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. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. It can be very difficult to interpret an MRI after a meniscus root repair. Oftentimes, after having a meniscus surgery, people are told that theyll be fine. Very reassuring, showed me X-rays and explained the healing process very clearly. I could no longer deadlift from the floor, and was having trouble squatting below parallel. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. He and his staff could not have been more helpful and professional. I think my clients thought I had lost my mind, but what else was I going to do? Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. In addition, there is no low age for meniscus repairs, with some root repairs being done in patients as young as 6 or 7 years old. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). 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. The other aspect that needs to be evaluated is the amount of extrusion of the meniscus. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. The American Journal of Sports Medicine. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. Driving after meniscus root repair depends on which knee it is. Phase I of Rehab: Surgery until 8 weeks. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. 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. 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. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. Wednesday: 8:00 am 5:00 pm Life happens and our bodies will sometimes let us down. Is this normal? First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. A meniscus root tear occurs when one or both of these roots tear away from the bone. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. 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. They have poor healing potential, and are extremely important to the stability and cushioning of the knee. Meniscus Repair. 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. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. 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. 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. It takes longer for a meniscus repair to heal than a meniscectomy. I have been walking and training normally for the past four and a half months. The incisions leave scars that usually fade in time. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. 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 It helps to be strong, my PT remarked. Your subscription could not be saved. Rehabilitation begins within a week of 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 ~. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. Appreciate the attention and time spent during office visits. with time whether there is healing or not. Sometimes the meniscus damage occurs more gradually as part of degeneration. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. You can't walk right after surgery. 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. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. Meniscus root repair is a surgery performed to repair a torn meniscus root. 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. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. Dr. Burnham was very thorough and took the time to explain what he thought my root problem may be, why, and how he suggested we proceed with my care. The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. Nothing. Surgical repair can successfully allow the meniscus to heal. Then I trained. A meniscus can become damaged due to sudden trauma. He will now be caring for my hip and knee in the future. I would recommend his services to anyone. 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. Highlights from the StartingStrength Community. Meniscal Ramp Lesions. Specializes in Orthopedic Reconstructive Surgery. Super knowledgeable. Patients are allowed to initiate weightbearing at 6 weeks, but should avoid any significant squatting, squatting and lifting, or sitting cross-legged for a minimum of 5-6 months. 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. No swelling. <>/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>> If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. If a patient does have a meniscus root tear and the cartilage in that same compartment is still relatively good or normal, a meniscus root repair would be indicated. 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. Highly recommended! 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. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. My name is Dr. David Middaugh. Realize that, as discussed above, the torn part of your meniscus was removed. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. Dr. Burnham made sure I knew what was happening and what could happen. The next portion of the Smith & Nephew root repair device is a mini First-Pass device. 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. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. Ibuprofen (Advil, Motrin) Naproxen (Aleve) A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. In this technique, sutures are placed into the torn meniscus root and then shuttled down tunnels in the tibia to tie the repair into place. 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. They are also important to the stability and function of the knee, keeping the meniscus in place. Really cares for his patients! He provided a thorough explanation without wasting time. But youre also not alone. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? Patients are allowed to walk 4-6 weeks after surgery. while avoiding unnecessary surgery, injections, and medications. Dr. Burnham performed my hip pin surgery and it all went extremely well. 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.