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Hence, that remaining meniscus is more and not less likely to tear again. (it is still a bit swollen). Wednesday: 8:00 am 5:00 pm Weight bearing as tolerated after 6 weeks. 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. Thanks to Dr. Burnham and his staff. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). And they can get back to normal in about two or three months after having the surgery. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. 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. Medication may be needed for 2-3 weeks. I'm able to run and exercise without pain. I also found that there were patients being referred to me who had meniscus root repairs that were done well, but the meniscus was not pulled back in the joint and these patients continued to have pain. Never disregard or delay professional medical advice in person because of anything on HealthTap. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. 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. 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. I could no longer deadlift from the floor, and was having trouble squatting below parallel. Their sense of compassion and understanding is more than we have ever experienced. The Steadman Clinic - Edwards, CO endobj As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. Heavy lifting, manual labor, strenuous exercise/activity, and sports should all be restricted until 3-6 months after surgery. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. Takes his time with you and doesn't hurry to rush out of the room if you have questions. The following Tuesday, I saw my doctor. Country. Super knowledgeable. Meniscus root repair rehab will usually start 1-2 days after surgery. He will now be caring for my hip and knee in the future. The second step is to prepare a bony bed where the meniscus repair will be performed. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. 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. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. Just its a big deal to take your time and let that cartilage heal at the rate that it heals you generally can go faster than what it heals, And the question that i get often is do i take any supplements glucosamine chondroitin those types of supplements and you know the answer to that is its not going to hurt we the research is kind of mixed on it sometimes it helps sometimes it doesnt help what we know is that it generally doesnt hurt it doesnt make it worse so youre not going to youre not going to make things worse if you decide to take those supplements are generally safe to take but some people report no difference. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. I would have relied strictly on physical therapy. I really like and appreciate the time and effort he commits to research. For this reason, much research has gone in to meniscus root repairs over the last several years. If so, you may be at risk of tearing the root of your meniscus. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. 2700 Vikings Circle Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. This is because the signs of arthritis are usually pain and swelling with activities. Patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs can expect a variation of the following: Dr. Nwachukwu is extremely knowledgeable about his area of expertise. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. This allows the meniscus to heal back to the bone. This is one of the first video demonstrations of this. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). while avoiding unnecessary surgery, injections, and medications. The next day, my left knee blew up to the size of a grapefruit. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. He and his staff could not have been more helpful and professional. 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. 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. 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. 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. There was absolutely no knee pain. 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. A meniscus root tear occurs when one or both of these roots tear away from the bone. Video chat with a U.S. board-certified doctor 24/7 in a minute. 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. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. Meniscal Ramp Lesions. My pain was gone. Meniscus root repair surgery recovery Most patients can return to full activity 4-6 months after a meniscus root repair. So lets get to it. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. I did a few jungle gym rows, and finished with planks. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. 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. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. 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. You can't walk right after surgery. It hurt like hell. If you break down what most healthcare provision professionals tell their patients, it could be an orthopedic surgeon, or even a physical therapist, its telling somebody whos just had a meniscus surgery, theyll say, well, 80% of healing is done in the first two to three months. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. He answered all my questions satisfactorily and his entire staff were polite and professional. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. Drivers: The meniscus repair surgery to prevent osteoarthritis is expected to drive market development. The torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. No swelling. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! Definitely recommend. I would highly recommend Dr Burnham and all of his surrounding colleagues at Ochsner. 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. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. Full recovery usually takes 6 months but can take up to 1 year. They are connected to your tibia by meniscal roots. 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. Can you tear your meniscus again after a surgery and if you do how can you tell? We had a wonderful experience and I highly recommend him. 1 0 obj 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. % 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. - Privacy Policy - Louisiana Retina, Dr. Jeremy Burnham, MD - Sports Medicine, Orthopedic Surgeon, Knee Doctor, Jeremy Burnham, MD - Sports Medicine & Orthopedic Surgeon, __CONFIG_colors_palette__{"active_palette":0,"config":{"colors":{"f3080":{"name":"Main Accent","parent":-1},"f2bba":{"name":"Main Light 10","parent":"f3080"},"trewq":{"name":"Main Light 30","parent":"f3080"},"poiuy":{"name":"Main Light 80","parent":"f3080"},"f83d7":{"name":"Main Light 80","parent":"f3080"},"frty6":{"name":"Main Light 45","parent":"f3080"},"flktr":{"name":"Main Light 80","parent":"f3080"}},"gradients":[]},"palettes":[{"name":"Default","value":{"colors":{"f3080":{"val":"rgb(23, 23, 22)"},"f2bba":{"val":"rgba(22, 23, 22, 0.5)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"trewq":{"val":"rgba(22, 23, 22, 0.7)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"poiuy":{"val":"rgba(22, 23, 22, 0.35)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"f83d7":{"val":"rgba(22, 23, 22, 0.4)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"frty6":{"val":"rgba(22, 23, 22, 0.2)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}},"flktr":{"val":"rgba(22, 23, 22, 0.8)","hsl_parent_dependency":{"h":120,"l":0.09,"s":0.02}}},"gradients":[]},"original":{"colors":{"f3080":{"val":"rgb(23, 23, 22)","hsl":{"h":60,"s":0.02,"l":0.09}},"f2bba":{"val":"rgba(23, 23, 22, 0.5)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.5}},"trewq":{"val":"rgba(23, 23, 22, 0.7)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.7}},"poiuy":{"val":"rgba(23, 23, 22, 0.35)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.35}},"f83d7":{"val":"rgba(23, 23, 22, 0.4)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.4}},"frty6":{"val":"rgba(23, 23, 22, 0.2)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.2}},"flktr":{"val":"rgba(23, 23, 22, 0.8)","hsl_parent_dependency":{"h":60,"s":0.02,"l":0.09,"a":0.8}}},"gradients":[]}}]}__CONFIG_colors_palette__, Cartilage Damage: Symptoms, Causes, & Treatment, Elbow Rehabilitation and Postoperative Protocols. 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. 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. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. My name is Dr. David Middaugh. . Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . And Im a specialist physical therapist El Paso manual physical therapy. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. Why would I? I highly recommend him. <>/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>> 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. Patients are usually kept non-weight bearing for the first 4-6 weeks, then advance gradually. 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. And people are often disappointed to find out that as they begin to get back to normal, as theyve been told that they probably could and should they start to get swelling in the knee, they start to get a pain, of course. His team is prompt, thorough, and fun - always smiles. An ACL tear most commonly occurs from a turning, twisting, or deceleration mechanism in a noncontact mode. Most importantly, I have not missed a single coaching or training session since my surgery. This may be recommended depending on the type of meniscus tear. I would recommend his service to any recreational athlete. Both my children have seen Dr. Burnham with great results. 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. My experience with Dr. Burnham and his staff was exceptional. Surgical repair can successfully allow the meniscus to heal. Two weeks. The thoughtful, open communication and treatment was everything I could have asked for pre-, during, and now post surgery. I rate him 5stars. 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. 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. Each horn is anchored to the bone at the meniscus root (anterior and posterior). 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. 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. Often, when a meniscus root is torn, it will retract in the joint and become stuck in place. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. 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. So its important at the very beginning its appropriate at the very beginning to make sure that all your emotions back and that you can do some simple walking to and from the house even though hurts so that youre not you know having accidents and better so youre not having emergencies happening you need the function of your leg back. Thank you. Therefore, a lateral meniscus root repair can be an essential portion of a surgery to address the secondary restrains for a concurrent ACL reconstruction procedure. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? And its a lot slower for the remaining, you know, six to nine months after the first two or three months. Dr. Burnham is amazing. 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. In particular, making sure the meniscus has a thorough release from scar tissue and making sure that ones sutures or UltraTape are placed into the best substance possible for the meniscus root repair, are important considerations to maximize the chance of healing of the revision root repair procedure. 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. This technique is fast and effective. Ive dealt with other knee doctors in prior injuries, but Dr. Burham and his team clearly stood out. And I feel my rode to recovery will be wonderful. I have two good arms, and a good leg. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. Swelling and stiffness. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. If I could give more than 5 stars, I would. 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. A surgical guide can then be placed in a drill tip where the cannula around it is placed into the area of the decorticated bone. Patients often report hearing a pop at the time of injury. 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. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. It helps to be strong, my PT remarked. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. 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. I decided right then and there I would not get the MRI. Partial weightbearing status (<50%), unless otherwise ordered by MD. Dr. Burnham has an awesome bedside manner. 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 He is amazing and a blessing to have in the medical industry. 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. Nothing. This technique allows for the meniscus to be pulled down into a broad surface area, maximizing its chance for biologic healing. That means that the remaining meniscus is smaller, but still taking the same pressure. What could you eat or do for a meniscus tear to heal faster after surgery? I dont remember how or when I tore my meniscus. I asked when I could start driving, and he said when I was off my pain medication. I opened my gym shortly after taking up strength training in earnest to help address my back pain, and have been working for the past eight years to help others embrace their true potential and strength. And cartilage is one of the slowest healing tissues in the body. Kyle D. Morgenstern, MD . A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. 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. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. And Im a specialist physical therapist El Paso manual physical therapy. So that means youre good to go after two to three months. 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. Figure 5:: Cortical fixation of transtibial meniscal root repair. You have two roots per meniscus which include anterior and posterior roots. Sit at home on the couch and watch T.V.? Sometimes the meniscus damage occurs more gradually as part of degeneration. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. 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 think my clients thought I had lost my mind, but what else was I going to do? 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. 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. Later that summer, the left knee began to bother meagain.