After about five minutes, the wheels were spinning. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. Ill def refer friends and family! Country. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. 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. I left my visit feeling very comfortable with where I was and what needed to happen next. Meniscus repair recovery While everyone's recovery is different, here's what you can typically expect with a repair surgery: You may be on crutches for four to six weeks. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. Dr. Burnham made sure I knew what was happening and what could happen. He is walking without a limb and is on schedule with his progress. The blood supply to the meniscus in an adolescent or adult is very poor. stream Oftentimes, after having a meniscus surgery, people are told that theyll be fine. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. What to do if I have a radial meniscus tear, what's the chance of it fully healing with surgery? 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. I'm able to run and exercise without pain. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. 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. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. Their sense of compassion and understanding is more than we have ever experienced. Please try again. By using our website, you consent to our use of cookies. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. 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. Your care after surgery may involve: Crutches to take stress off the knee as it heals. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. . For potential or actual medical emergencies, immediately call 911 or your local emergency service. Being aware of the location of the meniscal attachments at the time of ACL and PCL surgeries is essential to minimize the chance of an iatrogenic root tear. I never met a doctor and his team that showed some much compassion about their patient. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. Other non-medical modalities may help, such as using ice and elevating the leg. After a pretty serious car accident, Dr. Burnham performed knee surgery on me. 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. There are two menisci in the knee, medial and lateral. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? In particular, it has been found that one of the most common reasons why younger patients need total knee replacements is because of a neglected or undiagnosed meniscus root tear leading to the development of osteoarthritis. It helps to be strong, my PT remarked. No swelling. Meniscal root repair whether isolated or in combination with valgus HTO or ACL reconstruction, when indicated, was able to improve the clinical, functional and subjective results of the patients presented in this case series. And they can get back to normal in about two or three months after having the surgery. 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. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 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. 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 other aspect that needs to be evaluated is the amount of extrusion of the meniscus. As of August 20, 2019, it will be six months post-op. I highly recommend him. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. 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. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. I have now biked five to six days each week since my surgery. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. It is our goal to provide the highest level of care and service to our patients. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. importance of the meniscus root has become more apparent. Most patients will have pain with squatting and deep knee flexion with a root tear because a meniscus root tear occurs in the back of the knee. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right 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. 4 0 obj Dr Burnham is so personable. This technique is fast and effective. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. 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? PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. <>/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 patients are mostly allowed to walk immediately after arthroscopic knee surgeries. I really like and appreciate the time and effort he commits to research. Really cares for his patients! The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? I have two good arms, and a good leg. When I went in arthroscopically and thoroughly released the meniscus, pulling it back into an anatomic position and revising the repair; all of these patients seemed to have much improved pain relief. 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. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. I wasnt taking any pain medication either, so I was alert. And cartilage is one of the slowest healing tissues in the body. Appreciate the attention and time spent during office visits. Therefore, the patient should be worked up in a timely fashion when they do have a posterior horn medial meniscus root tear to determine if they are a candidate for a posterior horn medial meniscus transtibial root repair. 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. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . And people are often disappointed to find out that as they begin to get back to normal, as theyve been told that they probably could and should they start to get swelling in the knee, they start to get a pain, of course. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. I asked when I could start driving, and he said when I was off my pain medication. We had a wonderful experience and I highly recommend him. Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. The meniscus is a very important piece of cartilage in the knee. (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. short distances based on their motion and Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. When these are torn, the loading of the joint is equivalent to having no meniscus on the affected side. I would have relied strictly on physical therapy. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Oct 24, 2020. The most common complication after a meniscus root repair is a re-tear. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. 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. Ibuprofen (Advil, Motrin) Naproxen (Aleve) Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? 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 Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. This results in premature arthritis and cartilage damage in the knee. 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. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. It can be very difficult to interpret an MRI after a meniscus root repair. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. The thoughtful, open communication and treatment was everything I could have asked for pre-, during, and now post surgery. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. Weight bearing as tolerated after 6 weeks. Are you an athlete who participates in sports that involve running and jumping? But if we are stronger, we are harder to break, and we most certainly recover faster and better. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. 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. If one does a meniscus root repair in that extruded position, the chance of a meniscus root repair working over the long term is very minimal. 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. 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. We will determine during your consultation whether general or regional anesthesia would be appropriate - either way, no pain will be experienced during the procedure itself. And then they lose motion. 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. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. They moved my knee a bit, and I had decent ROM, better than expected. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Hence, that remaining meniscus is more and not less likely to tear again. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. Had a meniscus root repair yesterday and the surgery was successful. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Patients \50 years had outcomes similar to those of patients !50 years, as did . Most of these types of injuries, that are symptomatic, require surgery. Well, this is not normal. The pain during my recovery has actually only been minimal, requiring no pain meds. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. Highlights from the StartingStrength Community. The best surgeon is Baton Rouge that actually care about his patients!!! And theres things that you can do, which Ill allude to here in the middle. 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. They are connected to your tibia by meniscal roots. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. 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. Great doctor. 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. 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. 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. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. 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. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? He provided a thorough explanation without wasting time. We love you! Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. These are totally different. I decided right then and there I would not get the MRI. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. 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. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. 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. This may be recommended depending on the type of meniscus tear. General anesthesia and a nerve block. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. Specializes in Orthopedic Reconstructive Surgery. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Swelling and stiffness. I recommend him, as well as his staff, to anyone requiring such services. You'll likely regain your previous muscle strength in the leg by. I rate him 5stars. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. That night, I drove myself to the gym. I have successfully repaired meniscus root tears in patients that were 70 and 71 years old respectively and they are some of my happiest patients. I opened my gym shortly after taking up strength training in earnest to help address my back pain, and have been working for the past eight years to help others embrace their true potential and strength. I would recommend his services to anyone. I got a lift home, and returned to the gym later that evening for more coaching. Very positive experience at Bone and Joint Clinic in Baton Rouge. Phase I of Rehab: Surgery until 8 weeks. He answered all of my concerns about my knee. 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. 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. It hurt like hell. Fig 1 (A) Meniscus 4 A-II device. 1 0 obj Thank you Dr. Burnham and Jerrica for everything! very elderly patients). The knee buckled and I thought, Shit. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). 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. 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 would like to thank Dr. Jeremy Burnham for his wonderful work and surgery on my left shoulder. Medial Patellofemoral Ligament (MPFL) Reconstruction . I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. Very thorough, knowledgeable and courteous. Dr. Burnham has an awesome bedside manner. 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. What made my recovery so fast? This can occur in up to 20% of patients, even in the best of circumstances. 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. So you need to just have that expectation right now if youre going to go get a surgery, or if youve already had one, if its been more than six months, or youre in that you know, past six months, six to 12 months range or longer since your meniscus surgery, then its okay as long as you dont have another tear or some other massive injury to it, you can probably get that swelling under control, regain your motion back as long as it hasnt been too long. The procedure can be a complete meniscectomy where the meniscus and the . Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. 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. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. 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. I could no longer deadlift from the floor, and was having trouble squatting below parallel. 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. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . endobj But you need to still continue doing a few things to make sure that you get that remaining 20% healed so that you can truly get back to normal so let me give you some practical advice here three things that i want you to take away from this video number one set your expectations. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Is this a tear? The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . <>>> I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. If you're an athlete needing a doctor that understands; this is the guy. But its just not common knowledge to take six to 12 months to heal after a meniscus surgery. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. But now I know more about the body, about rehab, and about what being stronger really means. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. You can schedule an office consultation with Dr. LaPrade. 1) You must be off narcotic medications for a . A meniscus root tear can occur due to a traumatic event or degeneration. I went to Dr. Burnham for issues I was having with my shoulders. And its a lot slower for the remaining, you know, six to nine months after the first two or three months. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . He was outstanding. 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. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. - Privacy Policy - Louisiana Retina, Dr. Jeremy Burnham, MD - Sports Medicine, Orthopedic Surgeon, Knee Doctor, Jeremy Burnham, MD - Sports Medicine & Orthopedic Surgeon, __CONFIG_colors_palette__{"active_palette":0,"config":{"colors":{"f3080":{"name":"Main Accent","parent":-1},"f2bba":{"name":"Main Light 10","parent":"f3080"},"trewq":{"name":"Main Light 30","parent":"f3080"},"poiuy":{"name":"Main Light 80","parent":"f3080"},"f83d7":{"name":"Main Light 80","parent":"f3080"},"frty6":{"name":"Main Light 45","parent":"f3080"},"flktr":{"name":"Main Light 80","parent":"f3080"}},"gradients":[]},"palettes":[{"name":"Default","value":{"colors":{"f3080":{"val":"rgb(23, 23, 22)"},"f2bba":{"val":"rgba(22, 23, 22, 0.5)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"trewq":{"val":"rgba(22, 23, 22, 0.7)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"poiuy":{"val":"rgba(22, 23, 22, 0.35)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"f83d7":{"val":"rgba(22, 23, 22, 0.4)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"frty6":{"val":"rgba(22, 23, 22, 0.2)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"flktr":{"val":"rgba(22, 23, 22, 0.8)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}}},"gradients":[]},"original":{"colors":{"f3080":{"val":"rgb(23, 23, 22)","hsl":{"h":60,"s":0.02,"l":0.09}},"f2bba":{"val":"rgba(23, 23, 22, 0.5)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.5}},"trewq":{"val":"rgba(23, 23, 22, 0.7)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.7}},"poiuy":{"val":"rgba(23, 23, 22, 0.35)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.35}},"f83d7":{"val":"rgba(23, 23, 22, 0.4)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.4}},"frty6":{"val":"rgba(23, 23, 22, 0.2)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.2}},"flktr":{"val":"rgba(23, 23, 22, 0.8)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.8}}},"gradients":[]}}]}__CONFIG_colors_palette__, Cartilage Damage: Symptoms, Causes, & Treatment, Elbow Rehabilitation and Postoperative Protocols.