So that means youre good to go after two to three months. 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 recent years the importance of the meniscus root has become more apparent. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. 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. Can you tear your meniscus again after a surgery and if you do how can you tell? PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . And this channel is dedicated to helping people stay healthy, active and mobile. Few tears will become. The meniscus is a very important piece of cartilage in the knee. Does a extruded medial meniscus towards the posterior root need surgery? Very thorough, knowledgeable and courteous. The blood supply to the meniscus in an adolescent or adult is very poor. 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. So lets get to it. The exception is a patient that has contra-indications to surgery or already has too much cartilage wear and tear for the root repair to be beneficial. 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. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. Very reassuring, showed me X-rays and explained the healing process very clearly. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. You can't walk right after surgery. Figure 5:: Cortical fixation of transtibial meniscal root repair. 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. Then I trained. 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 . From April 22 until May 1, my program changed again, slowly becoming more like my regular training. 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. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. When these are torn, the loading of the joint is equivalent to having no meniscus on the affected side. Hence, that remaining meniscus is more and not less likely to tear again. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Other factors can also be present with extrusion, including the progression of arthritis which can cause a well-done meniscus repair to extrude outside the joint. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Appreciate the attention and time spent during office visits. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. Both my children have seen Dr. Burnham with great results. On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. Most importantly, I have not missed a single coaching or training session since my surgery. The thoughtful, open communication and treatment was everything I could have asked for pre-, during, and now post surgery. I really like and appreciate the time and effort he commits to research. I decided right then and there I would not get the MRI. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. The posterior roots are the most important as this is where a root tear occurs most commonly. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. And thats the 80% fact is true that does happen. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. I would recommend his service to any recreational athlete. 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. 5 stars! 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. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. I have see all three orthopedic doctors at the Grove and Jerrica is the one I see the most and the latest she's absolutely wonderful. His staff is very friendly and upbeat, knowledgeable and thorough. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. I was going to rehab myself, and keep training as normally as I could. I have now biked five to six days each week since my surgery. Dr. Burnham is amazing. And they can get back to normal in about two or three months after having the surgery. Is this a tear? The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . Please help. Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. So if youre sitting at home right now, and you just had your meniscus surgery a month or two ago, and youre thinking, gosh, why arent I much better already. %PDF-1.5 We recognized that meniscus root tears were a problem over 10 years ago and set out to perform a comprehensive research program to help us figure out how to diagnose the problem, where to place the meniscus repair, and how best to fix the meniscus tear to allow for maximal healing capability. 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. Are you a candidate for a meniscal root repair? Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 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. Meniscal Repair. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. My wait time for office visits has always been less than 10 minutes. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. 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. This is important because these repairs are still quite tenuous with current technology, so it is important to try to put the meniscus back into a position where there would not be a lot of tension on the repair with knee range of motion. 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 system also involves a drill with a cannula whereby one can drill through the tibial guide, see the drill bit come out inside the knee, and then pull the drill bit out and leave the cannula in place. Non-anatomic root repairs do not restore normal joint biomechanics . The meniscus is a piece of cartilage in the knee, often injured in sports. Dr. Burnham and his remarkable staff have been a godsend for our son. First, one needs to ensure that the meniscus root is repairable and that there is not too much arthritis on that affected portion of the joint such that a meniscus root repair would not be recommended. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. Im telling you right now its going to take six to 12 months just erase that number that they gave you in your head and i wouldnt go argue with them because they may not have all the knowledge and understanding behind it and truth be told surgeons oftentimes you know once they finish their surgery theyre kind of done with you. And if youve already had your meniscus surgery, then you know what to do so that youre not getting more swelling, pain and not losing motion than that knee and youre staying out of the surgeons office, so you dont have to go back again for another knee surgery. As of August 20, 2019, it will be six months post-op. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. endobj 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. 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. When I returned home around 1pm that day, I sat in my living room for a bit, emailing and texting people to let them know I was alive and well. 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. 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. It is shaped like a C and it serves to cushion and stabilize the knee. questions after your surgery, during business hours call 763-302-2231. Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. I'm able to run and exercise without pain. The therapists were a little surprised to see me so soon after my surgery, but I really wanted to know how much range of motion I had post-surgery. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. Fig 1 (A) Meniscus 4 A-II device. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. And they can get back to normal in about two or three months after having the surgery. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. He spent a great amount of time explaining everything to me in a way that I understood everything. 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. dressing in 48 hrs and may let them drive It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE . Strength is one of the most important aspects of our lives. Weight bearing as tolerated after 6 weeks. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. Most patients with meniscal root tears will ultimately need surgical fixation of the root. Many meniscus tears can be treated successfully without surgery. Please try again. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. Dr. Burnham clearly cares about his patients and their follow up care. It helps to be strong, my PT remarked. Nothing. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. 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. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. 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. Meniscus root repair rehab will usually start 1-2 days after surgery. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. 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. 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. <>>> Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. After meniscal surgery, rehabilitation with a physical therapist or athletic trainer is needed to restore range of motion, strength, movement control and guide the athlete's return to sport. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. 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 have two good arms, and a good leg. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. 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. 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. 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. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. drive the next day if they feel ok. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. 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. Your knee will be swollen. Why would I? Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. Really cares for his patients! 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 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. 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. No swelling. An ACL tear commonly has a pop on the outside of the knee, whereas a patient who has meniscus root tear commonly feels a pop in the back of the knee. The following Tuesday, I saw my doctor. Robert LaPrade, MD, PhD 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. I highly recommend Dr Burnham for your orthopedic needs hands down. The American Journal of Sports Medicine. 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.

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