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He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. 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. Video chat with a U.S. board-certified doctor 24/7 in a minute. 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. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . . Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. It was tough, and it hurt like hell, but I took it slowly. Really a national leader in sports medicine! Ibuprofen (Advil, Motrin) Naproxen (Aleve) We use the 2-tunnel technique to maximize biologic healing of the meniscus down to a broad surface. 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. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. The meniscus is a very important piece of cartilage in the knee. 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. Your care after surgery may involve: Crutches to take stress off the knee as it heals. <> There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. I have successfully repaired meniscus root tears in patients that were 70 and 71 years old respectively and they are some of my happiest patients. When I went in arthroscopically and thoroughly released the meniscus, pulling it back into an anatomic position and revising the repair; all of these patients seemed to have much improved pain relief. Ill def refer friends and family! 181 West Meadow Drive Suite 400 Vail, CO 81657. Takes his time with you and doesn't hurry to rush out of the room if you have questions. 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. Healing kind of goes fast the beginning and then it tapers off. This hoop stress is resisted by fibers that run circumferentially through the meniscus. 2601 E. Yandell Drive, Suite 232 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. You'll begin a graduated rehabilitation protocol. I am so glad I did! United States. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. But youve got to figure out a way to get your butt muscles stronger if youre looking for a more comprehensive plan for making your knee better and getting your glutes stronger we also have a program called the 28 day knee health and wellness boost program you can also find that in the link and as a link in the description below. We currently use UltraTape to do this. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. The next portion of the Smith & Nephew root repair device is a mini First-Pass device. Their sense of compassion and understanding is more than we have ever experienced. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . Meniscus Root Repair; Meniscus Transplantation; Partial Meniscectomy; Patellofemoral Joint Repair. I'm taking pain meds regularly to try and ease pain. Instead of wall slides, I opted for high box squats. Therefore, one should attempt a meniscus root repair whenever possible in most patients up to age 70. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. Do minor meniscus tears require surgery or can it repair itself? Everyone made us feel comfortable, and they were all polite and professional. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the I left my visit feeling very comfortable with where I was and what needed to happen next. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. When I woke up I was in significant pain but the nurses had it under control by the time I left. questions after your surgery, during business hours call 763-302-2231. Each week my leg brace is put to a different degree so I learn to bend my knee again. A meniscus root tear occurs when one or both of these roots tear away from the bone. If the patient has or has developed significant arthritis, which is usually designated at Kellgren-Lawrence grades 3 or 4, it is felt that a revision root repair may not be indicated. And cartilage is one of the slowest healing tissues in the body. 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. In fact 2 years ago I finished climbing the top 100 peaks in CO. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. It hurt like hell. Dr Burnhams bedside manner was exceptional. I really like and appreciate the time and effort he commits to research. Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. 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. 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 . Thanks to his staff for being so helpful. It is critical that patients following a knee joint repair refrain from squatting for at least four months after the procedure. 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. I am now adding 10 pounds a week to the bar for squats. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. 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. And now theyre kind of back to the way they were before the surgery. The first step is usually to use especially designed cannulas and guides to drill up into the area that was decorticated. This is important because these repairs are still quite tenuous with current technology, so it is important to try to put the meniscus back into a position where there would not be a lot of tension on the repair with knee range of motion. 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. Your subscription could not be saved. 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. 2018;47:762. 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. This can occur in up to 20% of patients, even in the best of circumstances. 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 . My pain was gone. 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. 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. The most common method to fix meniscus root tears is through a tibial bone tunnel. stream The next day, my left knee blew up to the size of a grapefruit. Great doctor. I did a few jungle gym rows, and finished with planks. Dr. Burnham was very helpful for my injury! The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . You can't walk right after surgery. If I had not spent the last several years of my life squatting, benching, pressing and deadlifting, I would not have had the strength to continue to be as active as I was after my surgery, and I most certainly would not have known how to rehab my knee on my own. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. He was outstanding. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. He did a great job of explaining both the progress of my injury and the way ahead as it applied to recovery. Are you an athlete who participates in sports that involve running and jumping? 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. I can run, bike, & climb mountains. 1 0 obj 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. short distances based on their motion and Removal Repair Example of Root Tear Repair Q: HOW DOES THE SURGEON DECIDE WHETHER TO PERFORM A REPAIR OR REMOVAL? Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Phase I of Rehab: Surgery until 8 weeks. The feeling that your knee is giving way, locking, or catching when you bend it. I highly recommend him. I finally decided to make an appointment with a knee specialist. I hope that you found hope now that if you got if you had a meniscus surgery in the past and youre dealing with these problems of swelling the pain the loss of motion please start doing this this taking this advice that i gave you start doing the exercises and get better it is possible to get that swelling down and to get your motion back and to recover and be normal. And thats all good if youre going to end up having the surgery. This technique is fast and effective. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Each horn is anchored to the bone at the meniscus root (anterior and posterior). Two 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. Great shoulder doc. 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. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. 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. And the good news is that it can be helped without another surgery. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. In addition, the other factor is if the meniscus was released significantly enough from scar tissue to pull it back into the joint. Both my children have seen Dr. Burnham with great results. I have been walking and training normally for the past four and a half months. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness.