Two important criteria exist to begin driving after meniscus surgery. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. Meniscus repair is usually done with arthroscopic surgery. Ibuprofen (Advil, Motrin) Naproxen (Aleve) 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. 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. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. 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 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 have two good arms, and a good leg. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. No swelling. In terms of when, one should plan to perform a meniscus root repair as soon as it is diagnosed as long as ones articular cartilage is still fairly intact. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. I could no longer deadlift from the floor, and was having trouble squatting below parallel. Sutures are passed through the meniscus, and then pulled down into a bone tunnel located at the same site as the root attachment before it tore. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. The blood supply to the meniscus in an adolescent or adult is very poor. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. A week later, I got my MRI results and I was told that this was going to be a very long recovery, but I had other plans. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. . I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. And cartilage is one of the slowest healing tissues in the body. Some patients may experience catching, clicking, or locking of their knee. The second tip i need you to take home today is you need to listen to your knee because after youre on your own and youre youre supposed to be 80% better theres things that youll be able to do and go ahead and do those as long as they dont hurt or bother you or cause some effects later on that day or the next day then theyre generally going to be okay things for you to do you can probably do some walking but walking you know a few miles maybe not very comfortable for you that may set off the swelling that may hurt you more. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. The procedure can be a complete meniscectomy where the meniscus and the . El Paso, Texas 79903. And this channel is dedicated to helping people stay healthy, active and mobile. 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. (Please keep reading below for more information on this treatment.). There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. Dr. Burnham is amazing. I really like and appreciate the time and effort he commits to research. Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? He is walking without a limb and is on schedule with his progress. A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. importance of the meniscus root has become more apparent. In recent years the importance of the meniscus root has become more apparent. The drill tip can then be pulled out, leaving the cannula in place, which allows one to place a passing stich up it to subsequently shuttle sutures down the tibial tunnel. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. 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. %PDF-1.5
You can schedule an office consultation with Dr. LaPrade. with time whether there is healing or not. His surgery and recovery has been perfect! I decided right then and there I would not get the MRI. 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. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. If you're an athlete needing a doctor that understands; this is the guy. 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 name is Dr. David Middaugh. (it is still a bit swollen). 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. The healing phase is long, but he does A+ work. It was tough, and it hurt like hell, but I took it slowly. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. The sutures are anchored to the tibia in order to stabilize the meniscus root attachment. Oct 24, 2020. Dr Burnham is so personable. So getting swelling, or if its been a year since you had your meniscus surgery, and youre better overall, but youre still getting some swelling and pain, then its normal. #12. Does a extruded medial meniscus towards the posterior root need surgery? Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. Each week my leg brace is put to a different degree so I learn to bend my knee again. He and his staff could not have been more helpful and professional. 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. 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. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . . Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. It can be very difficult to interpret an MRI after a meniscus root repair. He is amazing and a blessing to have in the medical industry. 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. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. 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. Created for people with ongoing healthcare needs but benefits everyone. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. Two weeks today I had meniscus root repair. A meniscus can become damaged due to sudden trauma. while avoiding unnecessary surgery, injections, and medications. Hence, that remaining meniscus is more and not less likely to tear again. The next day, my left knee blew up to the size of a grapefruit. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. 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. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? dressing in 48 hrs and may let them drive
Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. 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. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. You should also be able use your leg for driving after one to two weeks, as long as you're not taking opiate pain medication. His team is prompt, thorough, and fun - always smiles. So happy I found them! But the next day, I woke up and literally ran down my stairs. 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. In addition, if the medial meniscus is involved, active The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. Two weeks. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. The thoughtful, open communication and treatment was everything I could have asked for pre-, during, and now post surgery. Knee popping after meniscus surgery can occur due to fluid accumulation, scar tissue, swelling and stretching of the tendon and ligaments, weakened leg muscles, changes in patellar tracking, underlying knee arthritis, unstable meniscus, and inflamed plica. 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. I went to Dr. Burnham for issues I was having with my shoulders. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. Amazing Doctor and wonderful staff!! This can occur with turning, twisting, or pivoting activities or sports. You'll begin a graduated rehabilitation protocol. And this channel is dedicated to helping people stay healthy, active and mobile. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. These include 1-tunnel and 2-tunnel techniques. 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. What was going to help my knee? I sat down and put together a training program with exercises I could do, and trained four days a week as normal. Most meniscus root tears require surgery. Great doctor. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. 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. Doctors typically provide answers within 24 hours. Thank you for choosing Dr. LaPrade as your healthcare provider. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. We are so grateful and thankful. Therefore, we strongly advocate using a button to fix the meniscus sutures or tape on the tibia to minimize the chance of loosening over time. He was outstanding. However, we felt that with a 6-week period of being nonweightbearing important for all meniscus root tears, that the 2 simple suture technique was valid. I am now adding 10 pounds a week to the bar for squats. 1 doctor answer 2 doctors weighed in Dr. Jeffrey Sider answered Sports Medicine 41 years experience Depends: If surgery is on the left leg i let some patients drive the next day if they feel ok. Very thorough, knowledgeable and courteous. Dr. Burnham & his staff are very personable & caring. If not treated, part of the meniscus may come loose and slip into the joint. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. If scar tissue is present, Dr. Nwachukwu will clean up the area so the knee is allowed to move through its entire range of motion. Theyre kind of done with you too but what if you want to go play with the grandkids do you want to kneel what do you want to exercise youve got to set your expectations to still take it easy still rehab or strengthen the right muscles or do the right kind of treatment for yourself so that you can continue to heal. They have poor healing potential, and are extremely important to the stability and cushioning of the knee. questions after your surgery, during business hours call 763-302-2231. This allows the meniscus to heal back to the bone. amount of, supply and beyond the age of 15 has limited healing without surgery. So if youre sitting at home right now, and you just had your meniscus surgery a month or two ago, and youre thinking, gosh, why arent I much better already. You can't walk right after surgery. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. endobj
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. He listens and address every concern with appropriate solutions. 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. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. This is one of the first video demonstrations of this. I am a coach, and I have two boys playing sports, the best thing I can say is that my sons will go see Dr. Burnham in the event they are injured, and I will always recommend him to my athletes. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. The most common method to fix meniscus root tears is through a tibial bone tunnel. EDINA- CROSSTOWN OFFICE Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. And get the pain under control and recover normally the way that you should have once you start doing the right things. Dr Jeremy Burnham has a great way of interacting with his patients. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . 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. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. 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. The meniscus is a piece of cartilage in the knee, often injured in sports. Medial Patellofemoral Ligament (MPFL) Reconstruction . That night, I drove myself to the gym. My pain was gone. I would have relied strictly on physical therapy. 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. 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. I asked when I could start driving, and he said when I was off my pain medication. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. A patient who has a Meniscus (cartilage) repair cannot twist, pivot, squat, deep knee bends, or engage in any impact activities for four months. The . If not even worse. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. A meniscus root tear usually will not heal on its own. 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 I limped from the wedding venue to the car, and then from the car to my house. This may be recommended depending on the type of meniscus tear. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. Dr. Burnham was very helpful for my injury! 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. I highly recommend him. 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. Thanks to Dr. Burnham and his staff. 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. 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 incisions leave scars that usually fade in time. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. 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. 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. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the This can occur in up to 20% of patients, even in the best of circumstances. This happens way more often than I like to admit. Rehabilitation begins within a week of surgery. Prior to that, they are recommended to use crutches. He has repaired both of my shoulders and he is awesome to the max. Repetitive motions, overuse, and muscular imbalances ar twitter.com/i/web/status/1, Digging Deeper into the Data: Is Suture Bridge Repair + #PRP really the best technique for #rotatorcuffrepair? twitter.com/i/web/status/1, Wild Life of the Last #BlackJockey to Rule the #KentuckyDerby This is called decortication of the medial tibial plateau (for a medial meniscus root repair). The most common complication after a meniscus root repair is a re-tear. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. 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. 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. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. If the lateral meniscus root tear is not repaired at the same time as an ACL reconstruction, it is now recognized that this could lead to ACL graft failure or loosening over time. Fortunately, this is usually done arthroscopically and with good results. 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. 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. Browse archives. (B) Posterior root lesion of lateral meniscus. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. Meniscal Root Repair Post-operative Rehabilitation Protocol Phase 1: 0-2 weeks post-operatively Goals . 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. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. There are two menisci in the knee, medial and lateral. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist. 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. 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 goes my knee again.. Dr. Burnham has an awesome bedside manner. I rate him 5stars. I left my visit feeling very comfortable with where I was and what needed to happen next. And Im a specialist physical therapist El Paso manual physical therapy. He has a great rapport with teenagers. 1) You must be off narcotic medications for a . (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. 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. Range of motion exercises occur more slowly than a standard meniscus repair and will continue for the first 4 weeks. 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. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. A meniscal repair or arthroscopic meniscectomy is a surgical procedure to repair a torn meniscus via keyhole surgery. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. Thursday: 8:00 am 5:00 pm, What causes #runners knee or patellofemoral pain syndrome? 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. 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. I have been walking and training normally for the past four and a half months. I am so glad I did! Well, this is not normal. . In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. He spent a great amount of time explaining everything to me in a way that I understood everything. <>
Full recovery from meniscus surgery can take anywhere from six weeks to three months. On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. 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. The study included 351 patients with knee OA and meniscus tear. He had knee surgery a few months ago and is recovering remarkably well. 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. It was press/bench day, so I set up for some seated presses and dragged a stool over to prop my left leg up while I benched. And theres things that you can do, which Ill allude to here in the middle. These two steps are considered to be the two main preparation steps, where the release of adhesions to be able to allow the meniscus to be pulled back in the joint and also decortication of bone to prepare a bony bed to repair the meniscus back to the tibia. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. Walk with crutches. And cartilage is one of the slowest healing tissues in the body. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? 5 stars! A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. Repair of the meniscal root significantly increased functional outcomes scores in 14 of 14 studies and the rate of conversion to TKA was considerably less than those observed following conservative treatment or partial meniscectomy. <>>>
The following Tuesday, I saw my doctor. 3 0 obj
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. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. For potential or actual medical emergencies, immediately call 911 or your local emergency service. One should assess the range of motion at that point in time that can be performed in a safe zone to make sure that the physical therapist does not flex them harder in this time frame.