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You can't walk right after surgery. 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. 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. The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . Arthrex - Meniscal Root Repair This may be recommended depending on the type of meniscus tear. The Biggest Mistake People Make After Knee Meniscus Surgery I walked around the gym with the crutches, and without the crutches. Contact Dr. Nwachukwus team today! Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. 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. 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. Patients often report hearing a pop at the time of injury. Swelling and stiffness. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. Dr. Burnham was very helpful for my injury! Nothing. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. endobj He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. Many patients who do have a meniscus root tear note that they feel a pop in the back of the knee when they are doing squatting activities, such as cleaning floors, gardening, placing down carpet or plumbing. Meniscus Injury - Sports Medicine Research - Mayo Clinic You may need surgery to restore full knee function. In fact 2 years ago I finished climbing the top 100 peaks in CO. Dr. Burnham has an awesome bedside manner. Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. 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. 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. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. 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 root repair surgery recovery Most patients can return to full activity 4-6 months after a meniscus root repair. 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 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. Your knee will be swollen. Many patients do not have significant joint line pain like a typical meniscus tear, so having a patient stand up and squat down is often performed during the clinical exam to validate that the patient may have a meniscus root tear. And its really concerning and very disappointing for somebody whos gone through the knee surgery. Will Walking on a Torn Meniscus Make It Worse? Injury Care - Healthline Patients are allowed to walk 4-6 weeks after surgery. They are connected to your tibia by meniscal roots. There are some isolated reports of using suture anchors to repair a meniscus root repair, but this area of the knee is very difficult to access and the suture anchors can leave large knots which could subsequently interfere with the cartilage surfaces in the knee. I limped from the wedding venue to the car, and then from the car to my house. 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. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. It was glorious. After hours 763-520-7870 Address Maple Grove 9630 Grove Circle N., Suite 200 Maple Grove, MN 55369 Minnetonka 15450 Highway 7, Suite 100 Minnetonka, MN 55345 Robbinsdale 3366 Oakdale Ave. N Suite 103 Robbinsdale, MN 55422 Knee Meniscus Root . 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. endobj 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. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues. 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. My wait time for office visits has always been less than 10 minutes. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. Walk with crutches. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. I think my clients thought I had lost my mind, but what else was I going to do? We recommend the use of 2 cannulas such that the meniscus can be pulled down over a broader area and have a better chance of healing to the bone. 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. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. 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. Takes his time with you and doesn't hurry to rush out of the room if you have questions. I did a few jungle gym rows, and finished with planks. 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. Each horn is anchored to the bone at the meniscus root (anterior and posterior). One should not look at age as a factor for meniscus root repairs. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? 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. As a result, two weeks after surgery I was able to start driving my car, which is a manual. 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. Highlights from the StartingStrength Community. 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. Medial Meniscus Posterior Root Repair Using a Transtibial Technique It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Two weeks. During the procedure, Dr. Vidal will isolate the root, pull it against the tibia and place sutures in the meniscal attachment. 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. 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. Rehabilitation Following Meniscal Root Repair: A Clinical Commentary Hands down would recommend him!! 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. Your care after surgery may involve: Crutches to take stress off the knee as it heals. We are so grateful and thankful. 2018;47:762. 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. 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. 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. The RICE (rest, ice, compression, elevation) principle can be useful in the first several days after a meniscus tear to help reduce inflammation, swelling, and pain. But if we are stronger, we are harder to break, and we most certainly recover faster and better. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. Return to driving after surgery is okay once narcotic pain medication has been stopped and you are cleared by your surgeon. 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. In addition, there is no low age for meniscus repairs, with some root repairs being done in patients as young as 6 or 7 years old. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Very professional! That means that the remaining meniscus is smaller, but still taking the same pressure. 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. Call your doctor or 911 if you think you may have a medical emergency. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. I was worried for my future with my legs letting me walk but she put me at ease letting me know she will do everything in her power to fix me or send me to whatever specialist I need to see to make sure I have a good chance walking in my future, and they all truly fantastic doctors. The best surgeon is Baton Rouge that actually care about his patients!!! The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. 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. short distances based on their motion and Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. Dr Garcia demonstrates his new meniscal extrusion technique - YouTube Two weeks to the day, I got on my spin bike at the gym and did what I could do. Rehabilitation Following Meniscal Root Repair: A Clinical - JOSPT 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. In some severe cases, they cant fully extend their knee out or bend their knee all the way. Dr. Burnham is extremely professional, knowledgeable, understanding, kind, and precise. Meniscus Repair Surgery Rehab Protocol & Recovery Time - Kevin R. Stone On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. If your job mostly involves sitting at a desk, you may be able to get back to work in a week or two. 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. Dr. Robert F. LaPrade operated on my right knee in May of 2010. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. Protect repair Minimize pain Minimize swelling 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. 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. He answered all my questions satisfactorily and his entire staff were polite and professional. Life happens and our bodies will sometimes let us down. It can be very difficult to interpret an MRI after a meniscus root repair. The meniscus root is where the meniscus attaches to bone. Meniscal root tears: Solving the silent epidemic - Journal of Then I trained. The recovery time for meniscus surgery depends on the type of surgery you had. 5 stars! <>/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>> Appreciate the attention and time spent during office visits. 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? Does having a cortisone shot help a meniscus tear or is surgery the only option? We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. However, if the meniscus re-tore or is placed into a non-anatomic position and ones cartilage surfaces are still fairly intact, an attempt at a revision repair should be made. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . Posterior Meniscal Root Repair Using a Meniscal Suture Device Outcomes after Surgical Repair of Medial Meniscal Root Tears - PubMed Your doctor put a lighted tubecalled an arthroscope or scopeand other surgical tools through small cuts (incisions) in your knee. % I was going to rehab myself, and keep training as normally as I could. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. This is done to protect the repair and let the body heal it. One of the main portions of the system is a guide that can be placed inside the joint that fits around the tibial eminences and allows the surgeon to place the tip of the guide right at the area that has been decorticated of bone, where one wants to perform the root repair tunnel. Following this 6 weeks, they begin weight bearing at 25% with crutches for 1 week, and then 75% weight bearing using 1 crutch for 1 additional week. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. Because this is a frequent question posed on Google, I will try to be modest in answering this. Dr. Burnham took his time and answered all my questions with explanations. Meniscus Surgery: What to Expect at Home - Alberta . 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. And Im a specialist physical therapist El Paso manual physical therapy. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. My surgery was at 8:30am Wednesday, February 20. 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. Dr Burnham is so personable. 1 0 obj And slowly, I started bending the knee more, and eventually took the box away from my bench. My experience with Dr. Burnham and his staff was exceptional. Timeline: 1 week to 5 weeks after Surgery. Meniscal Repair - Physiopedia Meniscus Root Repair Northeast Philadelphia, PA | Meniscal Root Tears Is this a tear? 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. The most common root repair technique is called a transtibial technique. The patients are mostly allowed to walk immediately after arthroscopic knee surgeries. I'm taking pain meds regularly to try and ease pain. Meniscus Surgery: Who Needs It, What to Expect Before & After Most importantly, I have not missed a single coaching or training session since my surgery. In the end he offered the best treatment for me.This is the first time in months that I have felt myself. 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. Realize that, as discussed above, the torn part of your meniscus was removed. GREAT DOCTOR VERY CARING AND KNOWLEDGEABLE!! I dont remember how or when I tore my meniscus. Really a national leader in sports medicine! If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. So that means youre good to go after two to three months. How Long Is Recovery After a Meniscus Repair? Oftentimes healthcare providers will tell you go walk your knees operated on its good youre the we took out the chunk that was you know causing your need to lock up the meniscus we did a meniscectomy or we repaired the meniscus and its all sewn together now so you can go ahead and walk all you want and some people take that to heart and to go walk you know three miles a day or even 10-20 miles a week and their meniscus just doesnt heal enough and they get that swelling. During our biomechanical testing, we found that if we tied the sutures directly over bone, with cyclic loading, the sutures would cut into the bone and the repair would become loose over time. Dr. Burnham was very thorough with his examination and diagnosis. Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. Can You Walk Immediately After Meniscus Surgery? - eMedicineHealth So lets get to it. 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. Surgical repair can successfully allow the meniscus to heal. Meniscus Tear Surgery Recovery Time: When Can I Get Back to Work? I highly recommend him. What most people just dont get from their medical professionals is that the meniscus is a type of cartilage. Types of root tears: Thank you. Dr Jeremy Burnham has a great way of interacting with his patients. Deconditioning of ones quadriceps muscles can also cause similar symptoms, so it is important to determine if one has any atrophy of their thigh muscles, usually measured as the thigh circumference 15 cm above the patella and compared to the opposite leg. What Causes Knee Pain 1 Year After Meniscus Surgery? Darin helped me understand that it was going to be a very slow recovery due to the nature of the surgery, and to be patient. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Very thorough, knowledgeable and courteous. 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 . Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. PDF Coronal extrusion of the lateral meniscus does not increase after Meniscus Tears: Why You Should Not Let Them Go Untreated Untreated meniscus tears can increase in size and lead to complications, such as arthritis. There was absolutely no knee pain. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist. They can occur in younger patients as a result of high energy trauma, but are more common in patients between 45 and 60 as a result of degeneration of the meniscus with age. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 It can also occur while bending the knee deeply. You can schedule an office consultation with Dr. LaPrade. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. . Very positive experience at Bone and Joint Clinic in Baton Rouge. Both my children have seen Dr. Burnham with great results. 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. Definitely recommend. This answers all my questions! Meniscal Repair. It helps to be strong, my PT remarked. His staff is very friendly and upbeat, knowledgeable and thorough. I finally decided to make an appointment with a knee specialist. <>>> Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. 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. You may need to leave a message. I had a traumatic knee injury that he performed surgery on. The pain during my recovery has actually only been minimal, requiring no pain meds. Continuing to train, moving it as much as I could, bearing weight as much as I could tolerate, not sitting around, and NOT just doing PT exercises 1-2x times a week. 4. I chose not to use my crutches anymore. Later that summer, the left knee began to bother meagain. And they can get back to normal in about two or three months after having the surgery. If so, you may be at risk of tearing the root of your meniscus. But theres still healing to be done and that 20% is really critical. He listens and address every concern with appropriate solutions. What was going to help my knee? %PDF-1.5 Is this normal? I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. Never disregard or delay professional medical advice in person because of anything on HealthTap. Recommend highly. After meniscal surgery, rehabilitation with a physical therapist or athletic trainer is needed to restore range of motion, strength, movement control and guide the athlete's return to sport. 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. A meniscus can become damaged due to sudden trauma. They explain things very well. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. while avoiding unnecessary surgery, injections, and medications. 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. This allows the meniscus to heal back to the bone. stream 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. Partial weightbearing status (<50%), unless otherwise ordered by MD. This can occur in up to 20% of patients, even in the best of circumstances. Most of these types of injuries, that are symptomatic, require surgery. 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. The most common method to fix meniscus root tears is through a tibial bone tunnel. Definitely a Bakers Cyst, my doctor said when I saw him.