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Doctors typically provide answers within 24 hours. Meniscus Repair. They have poor healing potential, and are extremely important to the stability and cushioning of the knee. Dr. Ahmad M Hadied and another doctor agree, is on the left leg i let some patients Your subscription could not be saved. This may be recommended depending on the type of meniscus tear. The procedure can be a complete meniscectomy where the meniscus and the . I highly recommend Dr Burnham for your orthopedic needs hands down. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. This results in premature arthritis and cartilage damage in the knee. 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. How long after surgery for a meniscus tear will i be able to drive again. 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. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. It is vital that meniscus repair patients do not squat for at least four months after the repair. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. The aftercare and recovery require postoperative protection to allow healing. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. endobj Definitely a Bakers Cyst, my doctor said when I saw him. He answered all my questions satisfactorily and his entire staff were polite and professional. 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. Placing sutures or UltraTape on each side of the tear and pulling it down into tunnels should be a safe and reliable method for a bony avulsion root repair. My name is Dr. David Middaugh. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. The most common method to fix meniscus root tears is through a tibial bone tunnel. Full recovery usually takes 6 months but can take up to 1 year. 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. Monday: 8:00 am 5:00 pm And get the pain under control and recover normally the way that you should have once you start doing the right things. while avoiding unnecessary surgery, injections, and medications. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . This technically challenging procedure should only be done by an orthopedic knee expert like Dr. Nwachukwu who has had extensive experience in performing the meniscal root tear repair correctly. So lets get to it. 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 It is our goal to provide the highest level of care and service to our patients. I can run, bike, & climb mountains. The protocol is divided into phases. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. 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. You will begin to focus on regaining your ROM and begin more in muscle strengthening. 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. 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. 3 0 obj For this reason, much research has gone in to meniscus root repairs over the last several years. 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. The goal of a meniscus root tear repair is to locate the torn root and tack it back down to the bone using strong sutures. I got rid of the box for squats the end of July. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. 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. 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. He has repaired both of my shoulders and he is awesome to the max. Never disregard or delay professional medical advice in person because of anything on HealthTap. This is done to protect the repair and let the body heal it. In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint. Contact Dr. Nwachukwus team today! Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. Your care after surgery may involve: Crutches to take stress off the knee as it heals. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. Dr. Burnham was very thorough with his examination and diagnosis. Most of these types of injuries, that are symptomatic, require surgery. I decided right then and there I would not get the MRI. Very thorough, knowledgeable and courteous. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. Non-anatomic root repairs do not restore normal joint biomechanics . They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. Figure 5:: Cortical fixation of transtibial meniscal root repair. It takes longer for a meniscus repair to heal than a meniscectomy. They moved my knee a bit, and I had decent ROM, better than expected. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. An iatrogenic meniscus root tear means that a tunnel was drilled for an ACL or PCL reconstruction and hit the meniscus root and detached it from bone. 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. He provided a thorough explanation without wasting time. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. In particular, making sure the meniscus has a thorough release from scar tissue and making sure that ones sutures or UltraTape are placed into the best substance possible for the meniscus root repair, are important considerations to maximize the chance of healing of the revision root repair procedure. Very professional! GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! drive the next day if they feel ok. 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. We currently use UltraTape to do this. How long did you have to avoid driving after meniscus surgery? 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. This hoop stress is resisted by fibers that run circumferentially through the meniscus. 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. A meniscus root tear can occur due to a traumatic event or degeneration. 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. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. 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. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. Can you tear your meniscus again after a surgery and if you do how can you tell? EDINA- CROSSTOWN OFFICE 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. I would have relied strictly on physical therapy. Many meniscus tears can be treated successfully without surgery. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. The menisci in the knee are two c-shaped pieces of fibrocartilage that act as shock absorbers. Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. I was very pleased seeing Dr. Burnham, however I was not pleased to learn I was expected to pay an additional co- pay within the same week to receive the results of my MRI. 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. But theres still healing to be done and that 20% is really critical. 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. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. Yet, if you feel discomfort, you can take over-the-counter pain medication. What was going to help my knee? I felt very informed and well cared for. Types of root tears: It hurt like hell. I am now adding 10 pounds a week to the bar for squats. Meniscal root repair is a procedure that is performed to stabilize a torn meniscus attachment to the tibia (shinbone). The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. - 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. 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. I highly recommend him. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. 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. Two days after my surgery, Diego took me to my first PT session. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. These include 1-tunnel and 2-tunnel techniques. Meniscus root repair is a surgery performed to repair a torn meniscus root. My wait time for office visits has always been less than 10 minutes. The meniscus is a crescent-shaped pad of cartilage located in the knee that helps stabilize and . As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. 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. I switched from trap bar deadlifts to barbell rack pulls, continued to lower the box for squats and switched from single leg deadlifts to RDLs. Nothing. These radial root tears are equivalent to a meniscus root tear. 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. I would recommend his service to any recreational athlete. 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. Thank you Dr. Burnham and Jerrica for everything! Dr. Burnham and his staff were/are amazing. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. 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. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. Proper fixation of the meniscal root can prevent or slow down the development of arthritis in that area of the knee. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. Really a national leader in sports medicine! This happens way more often than I like to admit. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . I am currently on crutches for 6-8 weeks with no pressure on my leg at all. A lateral meniscus root tear involves a tear of the meniscus either at or close to the root attachment in the back part of the lateral meniscus. The knee buckled and I thought, Shit. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . He diagnosed the problem quickly and accurately. Weight bearing as tolerated after 6 weeks. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. And thats the 80% fact is true that does happen. In January of this year, I finally decided to go back to my doctor to get that MRI.