BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. Can you tear your meniscus again after a surgery and if you do how can you tell? 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. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. Conclusion: Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. I could no longer deadlift from the floor, and was having trouble squatting below parallel. I left my visit feeling very comfortable with where I was and what needed to happen next. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. Sometimes the meniscus damage occurs more gradually as part of degeneration. It has now been demonstrated that the results of meniscectomies are almost the same as not treating the meniscus root tear at all with a large number of patients within 5 years proceeding to needing a total knee arthroplasty. We recognized that meniscus root tears were a problem over 10 years ago and set out to perform a comprehensive research program to help us figure out how to diagnose the problem, where to place the meniscus repair, and how best to fix the meniscus tear to allow for maximal healing capability. After about five minutes, the wheels were spinning. Your knee will be swollen. Proper fixation of the meniscal root can prevent or slow down the development of arthritis in that area of the knee. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. 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. PDF Meniscal Root Repair Post-operative Rehabilitation Protocol Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. 2 0 obj Meniscal Root Repair Alone or Combined with Different Procedures After I would recommend his service to any recreational athlete. The American Journal of Sports Medicine. Meniscus Root Repair | Orthopedic Knee Surgeon | Vail, Aspen, Denver It can be very difficult to interpret an MRI after a meniscus root repair. Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? 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 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. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. I limped from the wedding venue to the car, and then from the car to my house. The Biggest Mistake People Make After Knee Meniscus Surgery Therefore, it is strongly recommended to proceed with a meniscus root repair whenever possible, with patients up to the age of 70 being reported as having excellent return of function. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. I decided right then and there I would not get the MRI. A written consent will be obtained from you after the surgical procedure has been explained in detail. He is walking without a limb and is on schedule with his progress. Is this normal? PDF Coronal extrusion of the lateral meniscus does not increase after 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. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. 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 asked when I could start driving, and he said when I was off my pain medication. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. The meniscus is a cushion of the knee joint. A meniscus root tear occurs when one or both of these roots tear away from the bone. You can't walk right after surgery. I wont ever go anywhere else. Thanks to Dr. Burnham and his staff. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. Their sense of compassion and understanding is more than we have ever experienced. 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. Later that summer, the left knee began to bother meagain. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. While you're recovering from your meniscus surgery, you can expect to feel pain while you heal. 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. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. They are also important to the stability and function of the knee, keeping the meniscus in place. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. Everyone I was in contact with, from support staff to Dr. Burnham, was kind, friendly, competent, and generous with time and information. Instead of wall slides, I opted for high box squats. We had a wonderful experience and I highly recommend him. Dr. Burnham and his staff were/are amazing. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. He is amazing and a blessing to have in the medical industry. If one has fairly normal cartilage of that side, the success rate is going to be better than those patients that have mild to moderate chondromalacia (arthritis) of the same compartment as the root repair. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. The meniscus root attachment is important because if the meniscus becomes detached, it can squirt out of the joint, called extrusion, which can lead to the meniscus not being functional. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. What could you eat or do for a meniscus tear to heal faster after surgery? Should a meniscus tear repair surgery be hurting 7 weeks post-operation? I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. Will Walking on a Torn Meniscus Make It Worse? Injury Care - Healthline Definitely recommend. 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. My wait time for office visits has always been less than 10 minutes. Patients are allowed to walk 4-6 weeks after surgery. Sit at home on the couch and watch T.V.? 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. You'll begin a graduated rehabilitation protocol. Im telling you right now its going to take six to 12 months just erase that number that they gave you in your head and i wouldnt go argue with them because they may not have all the knowledge and understanding behind it and truth be told surgeons oftentimes you know once they finish their surgery theyre kind of done with you. 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. The most important thing as one gets older is the quality of the cartilage present. 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. I rate him 5stars. Realize that, as discussed above, the torn part of your meniscus was removed. 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. Treatment Outcomes of Meniscal Root Tears: A Systematic Review 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 Full recovery usually takes 6 months but can take up to 1 year. Hands down would recommend him!! My daughter recovered fully from a total knee reconstruction and now she able to return to sports. This technique is fast and effective. Heres the third practical tip if youre if you dont know where to go Ive got some exercises that i put on videos here for free on YouTube its linked in the description below theres one video in particular that i want you to take a look at its called top five glute exercises for knee problems go check out that video start doing those exercises youve got to exercise the heck out of your glutes if you got a meniscus injury if youve had a meniscus surgery in the past you need to get your glutes worked out. Amazing Doctor and wonderful staff!! Appreciate the attention and time spent during office visits. HSS Sports Medicine Institute West Side A meniscus that still has extrusion present also does not function as well over the long term. 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. He provided a thorough explanation without wasting time. 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. A meniscus root tear can occur due to a traumatic event or degeneration. 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. 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. And its a lot slower for the remaining, you know, six to nine months after the first two or three months. My pain was gone. 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. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. I highly recommend him. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. When a tear of the meniscal root, or even a tear near the root, occurs, the meniscus can no longer convert axial loading forces into hoop stresses. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. Dr. Burnham and his remarkable staff have been a godsend for our son. Dr. Burnham has an awesome bedside manner. Takes his time with you and doesn't hurry to rush out of the room if you have questions. Nothing. Other common symptoms include limping, a change in the patients gait and the inability to put weight on the affected knee. As a result, two weeks after surgery I was able to start driving my car, which is a manual. It takes longer for a meniscus repair to heal than a meniscectomy. 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. . Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. Call your doctor or 911 if you think you may have a medical emergency. Two weeks today I had meniscus root repair. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. 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. Your subscription could not be saved. El Paso, Texas 79903. I started Brazilian Jiu-Jitsu about four years ago. very elderly patients). In addition, we looked at varying suture techniques through the meniscus, including 2 simple sutures, as well as other configurations of meniscus suture techniques, which are more complex. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. In this procedure, the torn meniscus is sewn back together using arthroscopy to place small stitches. Dr. Burnham was very thorough and took the time to explain what he thought my root problem may be, why, and how he suggested we proceed with my care. This allows the meniscus to heal back to the bone. He has repaired both of my shoulders and he is awesome to the max. . 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. Regular assessment of gait to avoid compensatory patterns. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. Kyle D. Morgenstern, MD . He diagnosed the problem quickly and accurately. The aftercare and recovery require postoperative protection to allow healing. 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. Two weeks. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. Further study into meniscus root tears and radial root tears is ongoing by our research laboratory to try to improve the treatment of these complex problems. 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 dont remember how or when I tore my meniscus. But if we are stronger, we are harder to break, and we most certainly recover faster and better. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. Meniscus repair rehab protocol. #12. Never disregard or delay professional medical advice in person because of anything on HealthTap. 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. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. % My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Now, the focus when you go into a surgeons office, theyre looking at your MRI, theyre looking at your meniscus on the MRI, theyre telling you the tear in the way that its torn and how theyre going to repair it. When these are torn, the loading of the joint is equivalent to having no meniscus on the affected side. importance of the meniscus root has become more apparent. He listens and address every concern with appropriate solutions. 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. 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. 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. while avoiding unnecessary surgery, injections, and medications. Return to Sport after Meniscus Surgery Chicago, IL | Dr. Jorge Chahla They might have a follow up visit or two but its really physical therapy that suppose take over at that point in physical therapy just has you for two to three months and once theyre done with you same thing once youre back to walking and bending your knee all the way and straightening out your knee all the way. 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. The meniscus has 3 main zones, the 1) posterior horn, the 2) body, and the 3) anterior horn. In recent years the importance of the meniscus root has become more apparent. 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. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. Meniscus repair is usually done with arthroscopic surgery. In fact 2 years ago I finished climbing the top 100 peaks in CO. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. Please try again. We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. Oct 24, 2020. Each week my leg brace is put to a different degree so I learn to bend my knee again. 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. Meniscus Repair. PDF Meniscus Root Repair Rehabilitation Protocol Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. Thank you. Many meniscus tears can be treated successfully without surgery. 2601 E. Yandell Drive, Suite 232 I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. And slowly, I started bending the knee more, and eventually took the box away from my bench. The knee buckled and I thought, Shit. 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. It helps to be strong, my PT remarked. Arthrex - Meniscal Root Repair Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. 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. Dr. Burnham is amazing. And then they lose motion. Dr. Benedict Nwachukwu, orthopedic knee surgeon has extensive experience in treating meniscus root tears and can help patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs. 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. Can You Walk Immediately After Meniscus Surgery? - eMedicineHealth Meniscal root avulsions are a challenging injury causing meniscal extrusion and loss of hoop stress distribution, which can lead to the development of knee arthritis.1 Securing the meniscus in a small bone socket has proven to be an effective means to restore hoop stresses and improve outcomes.2 The FlipCutter II reamer and meniscal root marking hook allow for a minimally invasive . And its really concerning and very disappointing for somebody whos gone through the knee surgery. And if we know anything about cartilage, if you want to look this up, it takes about six up to 12 months to fully heal depending on the severity of that injury on the meniscus on that cartilage. So lets get to it. repair to heal. Driving after meniscus surgery How soon can you drive after Arthroscopic Knee Surgery? The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. And now theyre kind of back to the way they were before the surgery.