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 . After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. This hoop stress is resisted by fibers that run circumferentially through the meniscus. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. Dr. Burnham and his remarkable staff have been a godsend for our son. A meniscus can become damaged due to sudden trauma. 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. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. At the end of March, my doctor told me I could take my brace off completely, and use crutches for another week if I needed to. The meniscus is a piece of cartilage in the knee, often injured in sports. My wait time for office visits has always been less than 10 minutes. 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. They are also important to the stability and function of the knee, keeping the meniscus in place. Keeping each meniscus in place are two roots that attach to the tibia (shin bone). 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. Prior to that, they are recommended to use crutches. 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. If not treated, part of the meniscus may come loose and slip into the joint. Because this is a frequent question posed on Google, I will try to be modest in answering this. Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. Are you an athlete who participates in sports that involve running and jumping? Recommend highly. Two days after my surgery, Diego took me to my first PT session. First, one needs to ensure that the meniscus root is repairable and that there is not too much arthritis on that affected portion of the joint such that a meniscus root repair would not be recommended. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. I really like and appreciate the time and effort he commits to research. And I feel my rode to recovery will be wonderful. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. And the good news is that it can be helped without another surgery. Great doctor. Meniscus repair rehab protocol. And then they lose motion. 1 0 obj I have been walking and training normally for the past four and a half months. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. The most common root repair technique is called a transtibial technique. 4. A Guide to Orthopedic Care, Pediatric & Adolescent Sports Medicine Injuries, Get the Perfect Grip on Your Next Game: Adaptive Golf Gloves, Healthcare Journal of Baton Rouge Mentions Dr. Burnham Performing New Surgery to Repair Torn ACL, Sports Medicine Near Me: Finding the Right Doctor for You, When to See a Doctor for Knee Pain When Bending: The Complete Guide, 11 Benefits of Exercise: It Can Change Your Life, Knee Bursitis: Causes, Symptoms, and Treatment Options, Your Childs Knocked Knees: Everything You Need to Know, BioUni OATS Procedure Cartilage Replacement for the Knee, Capsulorraphy Shoulder Stabilization Procedure. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. They are connected to your tibia by meniscal roots. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. Definitely recommend. Other non-medical modalities may help, such as using ice and elevating the leg. Highlights from the StartingStrength Community. I got rid of the box for squats the end of July. That means that the remaining meniscus is smaller, but still taking the same pressure. Dr. Burnham clearly cares about his patients and their follow up care. Realize that, as discussed above, the torn part of your meniscus was removed. Nothing. He was outstanding. I wasnt taking any pain medication either, so I was alert. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. 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 Later that summer, the left knee began to bother meagain. Walk with crutches. Ibuprofen (Advil, Motrin) Naproxen (Aleve) 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. Meniscus root repair is a surgery performed to repair a torn meniscus root. 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. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. 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. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . Now my intent on this video is not to throw anybody under the bus surgeons are doing the best they can with what they know and saw our physical therapists in any health care providers that you may be seeing for your meniscus problem. As a result, two weeks after surgery I was able to start driving my car, which is a manual. My name is Dr. David Middaugh. My calf swelled up into my ankles. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. 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. We currently use UltraTape to do this. In particular, these younger patients have to look at a meniscus root repair as soon as possible to ensure that they dont develop arthritis. It was glorious. The posterior roots are the most important as this is where a root tear occurs most commonly. By far the best orthopedic team I have ever met. 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 swelling started to go down, but there was now a lump behind my knee that felt like fluid. 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. 5 stars! 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. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Your doctor may give you a nerve block before surgery and will prescribe pain-relieving medications after surgery. Two weeks. In terms of how, the transtibial technique has been felt to be the most effective way to pull the meniscus root back to its normal attachment site. Dr. Burnham has an awesome bedside manner. Patients who have an ACL tear have a 10% chance of having a lateral meniscus root tear. Malempati C. Bonasia DE, Pellegrino P, DAmelio A, Cottino U, Rossi R. Meniscal Root Tear Repair: Why, When and How? Of patients treated with medial meniscal posterior root repair, 62.43% demonstrated complete healing on follow-up magnetic resonance imaging (MRI) or second-look arthroscopy. Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. Some patients may experience catching, clicking, or locking of their knee. If I could give more than 5 stars, I would. Video chat with a U.S. board-certified doctor 24/7 in a minute. HSS Sports Medicine Institute West Side Your care after surgery may involve: Crutches to take stress off the knee as it heals. I could no longer deadlift from the floor, and was having trouble squatting below parallel. 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. very elderly patients). Very professional! Most meniscus root tears require surgery. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. His surgery and recovery has been perfect! Non-anatomic root repairs do not restore normal joint biomechanics . 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. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. Figure 5:: Cortical fixation of transtibial meniscal root repair. In fact 2 years ago I finished climbing the top 100 peaks in CO. These results reveal that, since all the variables and possible concomitant injuries are investigated and addressed, MRR . Later that day, I trained. 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. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. We are so grateful for you both! The healing phase is long, but he does A+ work. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. 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. An ACL tear commonly has a pop on the outside of the knee, whereas a patient who has meniscus root tear commonly feels a pop in the back of the knee. And cartilage is one of the slowest healing tissues in the body. 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. It is shaped like a C and it serves to cushion and stabilize the knee. endobj I press and bench with no modifications. . The most important difference is that rehabilitation following a meniscal repair requires limiting early postoperative weight bearing and knee flexion beyond 90 degrees to . Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. And slowly, I started bending the knee more, and eventually took the box away from my bench. Tuesday: 8:00 am 5:00 pm Edina, MN 55435, EAGAN-VIKING LAKES OFFICE I went to Dr. Burnham for issues I was having with my shoulders. I would recommend his service to any recreational athlete. If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. But youre also not alone. Arrange for someone to drive you home as you will not be able to drive yourself after surgery. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential. Thank you. 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. Patients \50 years had outcomes similar to those of patients !50 years, as did . 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. He is amazing and a blessing to have in the medical industry. 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. Please subscribe to this channel and turn on your notifications so that you dont miss a single video with great tips and advice that we put out every single week. I left my visit feeling very comfortable with where I was and what needed to happen next. Robert LaPrade, MD, PhD 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. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. Dr. Burnham was very thorough with his examination and diagnosis. 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 . There are 2 main variants of the transtibial root repair technique. There are two menisci in the knee, medial and lateral. Therefore, any surgeon who performs ACL reconstruction should be well versed in performing a lateral meniscus root repair. I started Brazilian Jiu-Jitsu about four years ago. Identifying and properly treating meniscus tears (with or without surgery) will lead to the most rapid reduction in your symptoms and is crucial to optimize the long term health of your knee. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. Jerrica, Dr. Burnham, and the therapy staff (Luke and Joey )were awesome. That night, I drove myself to the gym. And this channel is dedicated to helping people stay healthy, active and mobile. It is important to recognize that most patients who sustain isolated meniscus root tears happen with a medial meniscus root attachment. So the focus of physical therapy after a knee meniscus surgery is getting your motion all the way back and then getting strong enough to stand and do some walking. Two weeks to the day, I got on my spin bike at the gym and did what I could do. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. We had a wonderful experience and I highly recommend him. Meniscus repair recovery While everyone's recovery is different, here's what you can typically expect with a repair surgery: You may be on crutches for four to six weeks. Surgical repair can successfully allow the meniscus to heal. The most important thing as one gets older is the quality of the cartilage present. Previous attempts to make it better provided only temporary relief. This allows the meniscus to heal back to the bone. 2601 E. Yandell Drive, Suite 232 Many meniscus tears can be treated successfully without surgery. I limped from the wedding venue to the car, and then from the car to my house. 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. He will now be caring for my hip and knee in the future. 1) You must be off narcotic medications for a . In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. 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. These are totally different. These two steps are considered to be the two main preparation steps, where the release of adhesions to be able to allow the meniscus to be pulled back in the joint and also decortication of bone to prepare a bony bed to repair the meniscus back to the tibia. Dr Burnhams bedside manner was exceptional. 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. In recent years the importance of the meniscus root has become more apparent. His step by step explanation of surgery expectations before and after the procedure was specific, thorough, and answered all of my questions. Therefore, most meniscus root tears need to have the scar tissue released so the meniscus can be pulled back into the joint. Sit at home on the couch and watch T.V.? 1 doctor answer 2 doctors weighed in Dr. Jeffrey Sider answered Sports Medicine 41 years experience Depends: If surgery is on the left leg i let some patients drive the next day if they feel ok. The study, " Patients Who Undergo Rotator Cuff Repair Can Safely Return to Driving at 2 Weeks Postoperatively ," was published online on July 21, 2022 in the Journal of Bone & Joint Surgery. Why would I? Few tears will become. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. 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. And they can get back to normal in about two or three months after having the surgery. 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. In addition, if the medial meniscus is involved, active Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: Clinical and economic effectiveness. 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. Most patients will also have some numbness around the surgical incision, but this is not a true complication and is anticipated with any type of surgical incision. There are many factors that go into this, including a patients weight, with overweight patients putting more stress on the meniscus root tear, ones alignment, where one being bowlegged with a medial meniscus root repair putting extra stress on the repair, and also the amount of underlying arthritis present prior to the root repair. 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. (it is still a bit swollen). He has repaired both of my shoulders and he is awesome to the max. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. If the patient is not comfortable walking without an aid, then they are usually provided with axillary crutches. A written consent will be obtained from you after the surgical procedure has been explained in detail. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. I asked when I could start driving, and he said when I was off my pain medication. Thank you for choosing Dr. LaPrade as your healthcare provider. And thats all good if youre going to end up having the surgery. First, we performed quantitative anatomy studies, which allowed us to see exactly where a meniscus root tear should be reattached.
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