As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. Super knowledgeable. And cartilage is one of the slowest healing tissues in the body. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. General anesthesia and a nerve block. Dr. Burnham took his time and answered all my questions with explanations. 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 28 day knee health and wellness boost program you can also find that in the link and as a link in the description below. #JimmyWinkfield is 1 of 5 men to win the prestigious twitter.com/i/web/status/1, What are #loosebodies in the #hip? Hence, that remaining meniscus is more and not less likely to tear again. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. You will begin to focus on regaining your ROM and begin more in muscle strengthening. Meniscus root tears usually occur in patients with deep flexion such as skiers, or home gardeners, plumbers, or carpet layers or people doing similar activities. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. 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. 2018;47:762. So that means youre good to go after two to three months. 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. This is one of the first video demonstrations of this. I recommend him, as well as his staff, to anyone requiring such services. 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. 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. Few tears will become. 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. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. He and his staff could not have been more helpful and professional. Most meniscus root tears require surgery. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. Begin passive range of motion exercises Start physical therapy or home exercise program 1-3 days after surgery Work on quad recruitment Brace/Crutch Use 25% weight bearing with crutches, brace 0-90 when ambulating and sleeping, can remove . A written consent will be obtained from you after the surgical procedure has been explained in detail. Never disregard or delay professional medical advice in person because of anything on HealthTap. %PDF-1.5 Being stronger is always better than being weak. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. 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 you're an athlete needing a doctor that understands; this is the guy. 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. While there are many factors that can go into extrusion, a maximum attempt should be made by the surgeon to try to pull the meniscus back in the joint to give the meniscus the best chance to function as a shock absorber after it heals. 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. 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. They walked me through the process from beginning to end. 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. 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. 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. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. Studies have demonstrated that this type of repair technique restores similar shock-absorbing and cushioning function as normal meniscus before it tore. Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. These are totally different. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. 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. Types of root tears: Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. <>>> They are also important to the stability and function of the knee, keeping the meniscus in place. 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. Dr. Burnham is amazing. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Unfortunately, as we have developed more scientific evidence for this, including several studies in my lab, we found that the lateral meniscus root is extremely important to both prevent the development of osteoarthritis over time and also to protect a concurrent ACL reconstruction graft. Full recovery from meniscus surgery can take anywhere from six weeks to three months. Other non-medical modalities may help, such as using ice and elevating the leg. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. We have published and validated our results in the peer-reviewed literature, which was at the time the largest series of meniscus root repairs reported. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Sit at home on the couch and watch T.V.? Squatting, lifting from a squat and sitting cross-legged should be avoided for 3-4 months. This allows the meniscus to heal back to the bone. % Both my children have seen Dr. Burnham with great results. The therapists were a little surprised to see me so soon after my surgery, but I really wanted to know how much range of motion I had post-surgery. We currently use UltraTape to do this. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. 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. 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. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. 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. Created for people with ongoing healthcare needs but benefits everyone. I have see all three orthopedic doctors at the Grove and Jerrica is the one I see the most and the latest she's absolutely wonderful. Yet, if you feel discomfort, you can take over-the-counter pain medication. 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. My experience with Dr. Burnham and his staff was exceptional. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. I have no issues taking the stairs, just a little knee discomfort here and there. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. The pain is usually located one the sides or front of the knee, although it can occasionally be located in the back of the knee. I decided right then and there I would not get the MRI. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. More diffuse pain over the inside of the knee which becomes progressive over time can be particular ominous because this may mean that the cartilage is wearing out fast or that one has an insufficiency fracture or spontaneous osteonecrosis of the knee, occurring due to the fact that the meniscus is such an important shock absorber. Appreciate the attention and time spent during office visits. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. questions after your surgery, during business hours call 763-302-2231. 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. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. The general published success rate for a meniscus root repair is between 80% and 85%. My pain was gone. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . In patients who have open growth plates, consideration may be necessary to either plan to remove the sutures after the meniscus root repair heals or to consider placing the tunnels and suture repair above the growth plate such that is does not cross the growth plate and have a theoretical chance of causing a growth plate arrest. 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. 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? W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. He listens and address every concern with appropriate solutions. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). EDINA- CROSSTOWN OFFICE Your subscription could not be saved. Fortunately, this is usually done arthroscopically and with good results. Instead of wall slides, I opted for high box squats. Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4 weeks postop. The most common root repair technique is called a transtibial technique. Phase I of Rehab: Surgery until 8 weeks. And thats the 80% fact is true that does happen. In general, patients have to develop good quadriceps strength to allow for maximum absorption with activities prior to returning back to any significant hiking, jogging or running activities. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. His extensive schooling, research, and commitment to his craft shined through at every turn as he evaluated my injury, presented all my options (clearly explaining non-surgical options and expected outcomes), and helped me plan my course of treatment and recovery. 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. And Im a specialist physical therapist El Paso manual physical therapy. I'm able to run and exercise without pain. Very reassuring, showed me X-rays and explained the healing process very clearly. Really cares for his patients! A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. You'll likely regain your previous muscle strength in the leg by. Had a meniscus root repair yesterday and the surgery was successful. 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. 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. Your knee will be swollen. Definitely recommend. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. 4. very elderly patients). BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. Untreated meniscus tears can increase in size and lead to complications, such as arthritis. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. 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. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. 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. Most root tears involve either a direct tear of the meniscus off bone or a split of the meniscus within 1 cm of the root attachment. Dr. Burnham was very personable and explained my situation in great detail. And this channel is dedicated to helping people stay healthy, active and mobile. He answered all my questions satisfactorily and his entire staff were polite and professional. I also started boxing sessions once a week with one of my coaches as I am not allowed to start back to BJJ until September. 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. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Two weeks. My wait time for office visits has always been less than 10 minutes. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness.

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