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. Can you tear your meniscus again after a surgery and if you do how can you tell? 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. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. Other complications can include a blood clot, which is usually treated preemptively with some type of blood thinner, and irritation around the surgical button and/or surgical knot from the meniscus root tear. Life happens and our bodies will sometimes let us down. Definition/Description. Ill def refer friends and family! One should not look at age as a factor for meniscus root repairs. Next, we performed biomechanical studies to show the effects of varying sizes of radial meniscus root tears, validating that a meniscus root tear within a centimeter of its attachment site functions as a meniscus root tear and can be treated the same. Most importantly, I have not missed a single coaching or training session since my surgery. Timeline for Meniscus Repair Recovery: It will take around 4-6 weeks before you can walk, drive, and otherwise move normally as you would prior to your injury. Very thorough, knowledgeable and courteous. I press and bench with no modifications. Does a extruded medial meniscus towards the posterior root need surgery? 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. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. 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. This is done to protect the repair and let the body heal it. But now I know more about the body, about rehab, and about what being stronger really means. In addition, because of studies from our biomechanical studies showing significant stress on the meniscus with deep flexion, as well as the fact that many meniscus root tears occur with deep flexion, we have patients avoid squatting, squatting and lifting and sitting cross-legged (which puts extra stress on a root repair) for a minimum of 4 months postoperatively to maximize the healing potential. Two weeks. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. This is one of the first video demonstrations of this. I got rid of the box for squats the end of July. 4 0 obj 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. Medial Patellofemoral Ligament (MPFL) Reconstruction . Medication may be needed for 2-3 weeks. 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. 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. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. Hands down would recommend him!! He and his staff could not have been more helpful and professional. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. I highly recommend him. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. Monday: 8:00 am 5:00 pm His MA Michelle was very professional and kind. Had a meniscus root repair yesterday and the surgery was successful. 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. 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. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the So the focus of physical therapy after a knee meniscus surgery is getting your motion all the way back and then getting strong enough to stand and do some walking. 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. There are many factors that go into this, including a patients weight, with overweight patients putting more stress on the meniscus root tear, ones alignment, where one being bowlegged with a medial meniscus root repair putting extra stress on the repair, and also the amount of underlying arthritis present prior to the root repair. <>/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>> A written consent will be obtained from you after the surgical procedure has been explained in detail. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Very positive experience at Bone and Joint Clinic in Baton Rouge. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Non-anatomic root repairs do not restore normal joint biomechanics . Great shoulder doc. 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. The next steps involve placing self-capture sutures into the end of the meniscus root and then drilling cannulas into the area that was decorticated such that the sutures placed into the meniscus can be shuttled down the cannulas and then tied over the tibia. In determining if one can have a revision root repair, one needs to determine the cause of the failure as well as the amount of underlying arthritis. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. 2601 E. Yandell Drive, Suite 232 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. Robert LaPrade, MD, PhD A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. (it is still a bit swollen). 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. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. 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. Meniscus root tears are a particularly troublesome type of meniscus tear, because a failure to treat them can often result in the rapid development of osteoarthritis. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. For potential or actual medical emergencies, immediately call 911 or your local emergency service. 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. Full recovery usually takes 6 months but can take up to 1 year. I walked around the gym with the crutches, and without the crutches. You can't walk right after surgery. If not treated, part of the meniscus may come loose and slip into the joint. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? You can schedule an office consultation with Dr. LaPrade. 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. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. Does having a cortisone shot help a meniscus tear or is surgery the only option? 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. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. Never disregard or delay professional medical advice in person because of anything on HealthTap. How long after surgery for a meniscus tear will i be able to drive again. 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. My experience with Dr. Burnham and his staff was exceptional. It was tough, and it hurt like hell, but I took it slowly. He was outstanding. I highly recommend him. Dr Burnham is so personable. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. 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. 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 had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. 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. The most common complication after a meniscus root repair is a re-tear. Video chat with a U.S. board-certified doctor 24/7 in a minute. He is on the cutting edge of research and techniques around surgery, he has a memorably reassuring bedside manner, and Im thankful he was in charge of my evalution and treatment. Currently, there are mini First-Pass devices that curve to the right and the left, which allows increased access to a root tear, especially since most root tears tend to squirt to the back part of the joint and can be more difficult to access with a straight biter. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 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. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. Dr Burnhams bedside manner was exceptional. I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. Are you a candidate for a meniscal root repair? 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. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. A meniscus root tear requires the meniscus to be repaired back to the lower leg bone; this is also performed arthroscopically. 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. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. What most people just don't get from their medical professionals is that the meniscus is a type of cartilage. 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. Everyone made us feel comfortable, and they were all polite and professional. I have no issues taking the stairs, just a little knee discomfort here and there. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. The meniscus is a very important piece of cartilage in the knee. He spent a great amount of time explaining everything to me in a way that I understood everything. I dont remember how or when I tore my meniscus. It is shaped like a C and it serves to cushion and stabilize the knee. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 Tuesday: 8:00 am 5:00 pm 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. Well, this is not normal. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. I have two good arms, and a good leg. Easy to talk to and will answer any questions of your care. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. There can be many factors which can potentially cause pain after a meniscus root repair. You'll likely regain your previous muscle strength in the leg by. The meniscus is a piece of cartilage in the knee, often injured in sports. Dr. Burnham made sure I knew what was happening and what could happen. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Using specific guides to ensure that one can place tunnels in the anatomic position and using self-capture devices, which have been devised to be small enough to not scuff up the cartilage, are some of the best means to perform a transtibial meniscus root repair with self-capture devices. If the patient has or has developed significant arthritis, which is usually designated at Kellgren-Lawrence grades 3 or 4, it is felt that a revision root repair may not be indicated. 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 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. It hurt like hell. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. 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. Super knowledgeable. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? The knee buckled and I thought, Shit. Timeline: 1 week to 5 weeks after Surgery. Takes his time with you and doesn't hurry to rush out of the room if you have questions. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. 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. endobj Dr. Burnham was very personable and explained my situation in great detail. It is our goal to provide the highest level of care and service to our patients.