They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. Heel lift in opposite shoe to normalize gait. This is probably due to many factors, including the chronicity of the tear, the quality of the tissue, if the meniscus was released from scar tissue and pulled back in the joint, ones age, ones weight, and ones alignment. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. This is one of the first video demonstrations of this. Full recovery from meniscus surgery can take anywhere from six weeks to three months. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. 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. My daughter journey was very trying and hard but we made it through with all of their help. Keeping each meniscus in place are two "roots" that attach to the tibia (shin bone). 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. In some cases, its important that you take away from this video today that it takes six to 12 months to heal from a meniscus surgery. Please try again. Some patients may experience catching, clicking, or locking of their knee. When one drills a tunnel and tries to place stitches up a tunnel without a cannula in place, it can be extremely technically challenging. with time whether there is healing or not. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture, What Does an Orthopedist Do? As of August 20, 2019, it will be six months post-op. When these are torn, the loading of the joint is equivalent to having no meniscus on the affected side. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. Dr. Burnham took time to explain the surgery & what to expect during recovery, answering all my questions (& there were many). The knee buckled and I thought, Shit. I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. Many tears have better outcomes if they are treated early. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. 4. Super knowledgeable. Dr Burnham is so personable. Most meniscus root tears occur very close to the root near the meniscus itself and are called radial root tears. Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. MENISCAL ROOT REPAIR POST-OPERATIVE ORDERS . If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. I started Brazilian Jiu-Jitsu about four years ago. Partial weightbearing status (<50%), unless otherwise ordered by MD. Then I trained. A meniscus root tear usually will not heal on its own. 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. There goes my knee again.. 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. You have two roots per meniscus which include anterior and posterior roots. Really cares for his patients! Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 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 got a lift home, and returned to the gym later that evening for more coaching. This is because a lack of meniscus attachment at the root causes extra stress to be placed on an ACL graft and it can also result in the patient having more instability, both with anterior tibial translation, and with twisting and turning activities during the pivot shift, when there is a concurrent lateral meniscus root tear. My MRI showed an extensive radial tear adjacent to the medial meniscus root insertion, as well as evidence of high-grade chondral loss involving the central trochlea. <> The next portion of the Smith & Nephew root repair device is a mini First-Pass device. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. But youre also not alone. 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. 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. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. I would highly recommend him. It was glorious. Dr. Burnham clearly cares about his patients and their follow up care. In general, patients have to develop good quadriceps strength to allow for maximum absorption with activities prior to returning back to any significant hiking, jogging or running activities. They moved my knee a bit, and I had decent ROM, better than expected. If one has too much arthritis, then the chance of a meniscus root repair helping one to slow down the progression of arthritis is probably not worth having the meniscus root repaired. Very reassuring, showed me X-rays and explained the healing process very clearly. 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. He is on the cutting edge of research and techniques around surgery, he has a memorably reassuring bedside manner, and Im thankful he was in charge of my evalution and treatment. What made my recovery so fast? endobj Other non-medical modalities may help, such as using ice and elevating the leg. I'm taking pain meds regularly to try and ease pain. In the early stages of your meniscus tear you can take these conservative and essential treatments which are as follows: Rest Ice every 15 minutes in every 4-6 hours Compression with an ACE wrap or sleeve Elevation of the leg Nonsteroidal anti-inflammatory medications (NSAIDs) for pain. 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 next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. Thank you. One should not look at age as a factor for meniscus root repairs. Diego has an automatic and it was my left knee that was incapaciated, not my right, so the next day, I hobbled into his car and practiced driving around the block. 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. Very thorough, knowledgeable and courteous. And cartilage is one of the slowest healing tissues in the body. 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. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). 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. 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. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. My repair will be later this week on my right leg. One of the most common is in patients who may have some underlying arthritis and the arthritis is causing the pain or the arthritis has progressed further after the meniscus root repair. Please help. Most importantly, I have not missed a single coaching or training session since my surgery. I have no issues taking the stairs, just a little knee discomfort here and there. 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. By using our website, you consent to our use of cookies. After you have surgery to repair a meniscus tear, you may need to build up your strength in the muscles of your leg that support your knee. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. If there is tissue there, it usually means that the meniscus root repair has healed down to bone. No swelling. 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. Hence, that remaining meniscus is more and not less likely to tear again. Hands down would recommend him!! If not treated, part of the meniscus may come loose and slip into the joint. W;5$u4Yxa_V_bm}q8=^_qbY,H(+",X'{|oMs"&A;3.E s&L=Z`)!]$],b }zb& Y@dy.Lif1:4@"Fz"U2`/h0|6^T&}56+Q:Dn{d:rqW@3 7 U. Everyone made us feel comfortable, and they were all polite and professional. 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. You will begin to focus on regaining your ROM and begin more in muscle strengthening. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. The incisions leave scars that usually fade in time. <> 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. The best surgeon is Baton Rouge that actually care about his patients!!! There are two menisci in the knee, medial and lateral. Patients are allowed to walk 4-6 weeks after surgery. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. Two weeks. 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. Iatrogenic meniscus root tears have been described for all 4 meniscal attachments in the knee. 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.