Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 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 got a lift home, and returned to the gym later that evening for more coaching. His team is prompt, thorough, and fun - always smiles. Doctors typically provide answers within 24 hours. 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 . After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. Now my intent on this video is not to throw anybody under the bus surgeons are doing the best they can with what they know and saw our physical therapists in any health care providers that you may be seeing for your meniscus problem. My experience with Dr. Burnham and his staff was exceptional. 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. 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. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. If I had not spent the last several years of my life squatting, benching, pressing and deadlifting, I would not have had the strength to continue to be as active as I was after my surgery, and I most certainly would not have known how to rehab my knee on my own. Two weeks. Great doctor. 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. 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. 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. When you put weight on your leg, it is the meniscal roots that transfer the axial loading forces of the knee into hoop stress in the meniscus. 4. As a result, two weeks after surgery I was able to start driving my car, which is a manual. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. The most important aspect to assess when one is looking at a root repair is to ensure that ones cartilage surfaces are still fairly normal. In addition, if the medial meniscus is involved, active And they can get back to normal in about two or three months after having the surgery. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. 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. The American Journal of Sports Medicine. It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. I had a traumatic knee injury that he performed surgery on. This is because a lack of meniscus attachment at the root causes extra stress to be placed on an ACL graft and it can also result in the patient having more instability, both with anterior tibial translation, and with twisting and turning activities during the pivot shift, when there is a concurrent lateral meniscus root tear. 5 stars! Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Thank you for choosing Dr. LaPrade as your healthcare provider. I am now adding 10 pounds a week to the bar for squats. 28323545 Additionally, preparing 2 transtibial tunnels to secure the meniscal root to its attachment site further increases the 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. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. Many meniscus tears can be treated successfully without surgery. If one does have quite a bit of arthritis of the same compartment, which we would call Kellgren-Lawrence grades 3 or 4, in most circumstances, other than possibly in very young patients, a root repair would generally not be indicated. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. 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. And Im a specialist physical therapist El Paso manual physical therapy. questions after your surgery, during business hours call 763-302-2231. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. You may need surgery to restore full knee function. This can occur in up to 20% of patients, even in the best of circumstances. 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 highly recommend Dr Burnham for your orthopedic needs hands down. Rehabilitation begins within a week of surgery. I walked around the gym with the crutches, and without the crutches. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Call your doctor or 911 if you think you may have a medical emergency. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. 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. I have no issues taking the stairs, just a little knee discomfort here and there. In January of this year, I finally decided to go back to my doctor to get that MRI. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. 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. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. If the surgery is on the right leg i change to Other non-medical modalities may help, such as using ice and elevating the leg. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. I started Brazilian Jiu-Jitsu about four years ago. 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. Robert LaPrade, MD, PhD 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. It helps to be strong, my PT remarked. <>/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>> 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. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. There goes my knee again.. A torn meniscus can result in either sudden or gradual onset of pain. Non-anatomic root repairs do not restore normal joint biomechanics . Meniscus root repair rehab will usually start 1-2 days after surgery. It can be very difficult to interpret an MRI after a meniscus root repair. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. 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. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. This results in premature arthritis and cartilage damage in the knee. One of the main portions of the system is a guide that can be placed inside the joint that fits around the tibial eminences and allows the surgeon to place the tip of the guide right at the area that has been decorticated of bone, where one wants to perform the root repair tunnel. But if we are stronger, we are harder to break, and we most certainly recover faster and better. There was absolutely no knee pain. 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. Are you a candidate for a meniscal root repair? This technique is fast and effective. By using our website, you consent to our use of cookies. 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. Surgical repair can successfully allow the meniscus to heal. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. A written consent will be obtained from you after the surgical procedure has been explained in detail. I left my visit feeling very comfortable with where I was and what needed to happen next. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. endobj I decided right then and there I would not get the MRI. Meniscus root repair is a surgery performed to repair a torn meniscus root. 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. What could you eat or do for a meniscus tear to heal faster after surgery? with time whether there is healing or not. You'll likely regain your previous muscle strength in the leg by. Heel lift in opposite shoe to normalize gait. 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. The blood supply to the meniscus in an adolescent or adult is very poor. 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. My wait time for office visits has always been less than 10 minutes. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. Thank you Dr. Burnham for being so amazing! Please try again. <> If you break down what most healthcare provision professionals tell their patients, it could be an orthopedic surgeon, or even a physical therapist, its telling somebody whos just had a meniscus surgery, theyll say, well, 80% of healing is done in the first two to three months. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. Two days after my surgery, Diego took me to my first PT session. 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. It can also occur while bending the knee deeply. Sometimes the meniscus damage occurs more gradually as part of degeneration. And thats the 80% fact is true that does happen. I am currently on crutches for 6-8 weeks with no pressure on my leg at all. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. 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. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. He spent a great amount of time explaining everything to me in a way that I understood everything. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 And they can get back to normal in about two or three months after having the surgery. It was glorious. Dr. Burnham was very helpful for my injury! Procedure for Meniscus Root Repair. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. 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. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. 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, https://www.epmanualphysicaltherapy.com/wp-content/uploads/2020/01/Logo-copy-1030x429.jpg, Shoulder Impingement: Everything You Need To Know To Get Healthy Again, Top 5 Shoulder Impingement Exercises To Help Get Healthy Again, Top 6 At Home Treatments To Begin To Naturally Heal Cervical Radiculopathy, Click Here To Schedule A Phone Call With An Expert, Click Here To Ask About Cost & Availability, Copyright 2022 - El Paso Manual Physical Therapy, How To Tell If Youve Got A Rotator Cuff Tear, Request A Virtual Visit With One Of Our Expert PTs, 28 day knee health and wellness boost program, 28-Day Knee Health & Wellness Boost Program, 28 Day Back Health & Wellness Boost Program. Some patients may experience catching, clicking, or locking of their knee. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. If it is your right knee, it will be at least a week before you can drive, as it would be risky to have to hit the break too soon after surgery, and you would be a risk to yourself and everyone else on the road. The meniscus is a very important piece of cartilage in the 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.