Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 5 stars! 2700 Vikings Circle That night, I drove myself to the gym. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. 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. 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. 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. 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. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Call your doctor or 911 if you think you may have a medical emergency. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. Most patients with meniscal root tears will ultimately need surgical fixation of the root. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. 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. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients %PDF-1.5 Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. The general published success rate for a meniscus root repair is between 80% and 85%. Because this is a frequent question posed on Google, I will try to be modest in answering this. Sit at home on the couch and watch T.V.? Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . These radial root tears are equivalent to a meniscus root tear. 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. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. What could you eat or do for a meniscus tear to heal faster after surgery? I finally decided to make an appointment with a knee specialist. The aftercare and recovery require postoperative protection to allow healing. While there are a small number of patients who do have their meniscus root re-tear, this has been nowhere near as common as the other sources noted above. Highlights from the StartingStrength Community. 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. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. 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. Thus, when one does sustain a lateral meniscus root tear with an ACL tear, consideration should be given to having a concurrent lateral meniscus root repair so the ACL graft does not stretch out. This is one of the first video demonstrations of this. 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. 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. No swelling. 1 0 obj Thank you. My name is Dr. David Middaugh. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. 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 torn fragment is floating in the joint, patients will feel a sudden, sha, According to an injury study done in 2021, #Pickleball has been deemed safer than #tennis and better for individual, 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. My calf swelled up into my ankles. And its really concerning and very disappointing for somebody whos gone through the knee surgery. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. That was day one. We are so grateful for you both! In our hands, because we have performed many second look arthroscopies, we have found that the 2-tunnel technique allows for a broader surface area of the meniscus against the decorticated bone and seems to allow for a more solid and secure repair. 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. 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. 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 beginning of April, I was dancing at a friends wedding when I suddenly heard and felt a loud pop in my left knee. Now, the focus when you go into a surgeons office, theyre looking at your MRI, theyre looking at your meniscus on the MRI, theyre telling you the tear in the way that its torn and how theyre going to repair it. Country. Many meniscus tears can be treated successfully without surgery. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. 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. This answers all my questions! In the end he offered the best treatment for me.This is the first time in months that I have felt myself. 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. 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. 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. I dont remember how or when I tore my meniscus. Protect repair Minimize pain Minimize swelling 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. They are also important to the stability and function of the knee, keeping the meniscus in place. Surgical repair can successfully allow the meniscus to heal. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. The average pain levels after a meniscus root repair fit between a basic knee arthroscopy (minimal pain) and an ACL reconstruction (more severe pain). 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. And if youve never worked out your glutes if you went through physical therapy never really targeted your glutes ever you better start quick because chances are youve got a muscle imbalance thats caused extra pressures inside your knee thats led to that meniscus tear to begin with thats been the root problem and glute strength is what offsets that forces inside the knee so that your meniscus can heal all the way. They walked me through the process from beginning to end. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. How long recovery takes depends on the type of meniscus surgery and the severity of the injury, but expect two weeks down time, at minimum. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. Dr Burnhams bedside manner was exceptional. The posterior roots are the most important as this is where a root tear occurs most commonly. I would recommend his services to anyone. 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. 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. There can be many factors which can potentially cause pain after a meniscus root repair. I went to Dr. Burnham for issues I was having with my shoulders. Meniscus root repair surgeon, Doctor Benedict Nwachukwu provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, New York City, NY who need meniscus root repair surgery. Two weeks. Appreciate the attention and time spent during office visits. I was told it would be about 6 weeks, but my instructions are to wear a brace at full extension for the duration of this time. questions after your surgery, during business hours call 763-302-2231. 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. Can you tear your meniscus again after a surgery and if you do how can you tell? Hands down would recommend him!! 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. 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. El Paso, Texas 79903. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. United States. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. I could no longer deadlift from the floor, and was having trouble squatting below parallel. The meniscus is a cushion of the knee joint. And Im a specialist physical therapist El Paso manual physical therapy. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. And thats the 80% fact is true that does happen. Thus, these patients can often have early onset arthritis, the development of bony edema, insufficiency fractures, and the failure of concurrent cruciate ligament reconstruction grafts. Prior to Starting Strength, I would have simply gone to physical therapy, done my exercises like the therapist told me to do, and that would have been it. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. 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. 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. There are 2 main variants of the transtibial root repair technique. Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? 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. 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. 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. Most meniscus root tears require surgery. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. 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. Most importantly, I have not missed a single coaching or training session since my surgery. I decided to continue with my usual four day split with two upper body days and two lower body days, although I did also incorporate a few extra upper body exercises as my lower body work was not that intense. I was adding 10 pounds a week for deadlifts but have now switched to pause deadlifts on Tuesday and add only 5 pounds a week to the heavy deadlift. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. 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. Some patients may experience catching, clicking, or locking of their knee. Other sources of pain can include scarring within the joint that occurs as a normal part of a surgical procedure, or pain from other pathology and joint, such as arthritis under the kneecap. 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. 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. I had a traumatic knee injury that he performed surgery on. 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. What do you suggest if my MRI says that I have a horizontal tear in the body of the lateral meniscus is shown do I need surgery? But now I know more about the body, about rehab, and about what being stronger really means. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Weight bearing as tolerated after 6 weeks. Healing kind of goes fast the beginning and then it tapers off. 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. 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 Untreated meniscus tears can increase in size and lead to complications, such as arthritis. Had a meniscus root repair yesterday and the surgery was successful. 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. I have now biked five to six days each week since my surgery. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. Well, this is not normal. EDINA- CROSSTOWN OFFICE If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. Two important criteria exist to begin driving after meniscus surgery. Fig 1 (A) Meniscus 4 A-II device. The blood supply to the meniscus in an adolescent or adult is very poor. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. It was tough, and it hurt like hell, but I took it slowly. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. 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. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. 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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