Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . (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. Most meniscus root tears require surgery. 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. And thats all good if youre going to end up having the surgery. In our hands, because we have performed many second look arthroscopies, we have found that the 2-tunnel technique allows for a broader surface area of the meniscus against the decorticated bone and seems to allow for a more solid and secure repair. I would recommend his service to any recreational athlete. We found that the technique was very successful at restoring function to patients and significantly reducing their pain. However, we felt that with a 6-week period of being nonweightbearing important for all meniscus root tears, that the 2 simple suture technique was valid. Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. Weight bearing as tolerated after 6 weeks. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . 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. Specializes in Orthopedic Reconstructive Surgery. So that means youre good to go after two to three months. 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. He has repaired both of my shoulders and he is awesome to the max. When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the I continued to lower the box for squats, and started to add weight. Being stronger is always better than being weak. I walked around the gym with the crutches, and without the crutches. We validated that the 2 simple suture technique had the least amount of loosening over time, but the other techniques were stronger. In patients who have open growth plates, consideration may be necessary to either plan to remove the sutures after the meniscus root repair heals or to consider placing the tunnels and suture repair above the growth plate such that is does not cross the growth plate and have a theoretical chance of causing a growth plate arrest. I got rid of the box for squats the end of July. 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. (E) Horizontalized FlipCutter drill ready to drill 10-mm-deep tibial tunnel. 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. 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 . It is shaped like a C and it serves to cushion and stabilize the knee. Im telling you right now its going to take six to 12 months just erase that number that they gave you in your head and i wouldnt go argue with them because they may not have all the knowledge and understanding behind it and truth be told surgeons oftentimes you know once they finish their surgery theyre kind of done with you. 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. Two weeks to the day, I got on my spin bike at the gym and did what I could do. The first 6 weeks are a strict protection phase and the patient is non-weight bearing. I really like and appreciate the time and effort he commits to research. 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. This answers all my questions! In recent years the importance of the meniscus root has become more apparent. Repair of the meniscal root significantly increased functional outcomes scores in 14 of 14 studies and the rate of conversion to TKA was considerably less than those observed following conservative treatment or partial meniscectomy. We love you! I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. 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. Protect repair Minimize pain Minimize swelling A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. EDINA- CROSSTOWN OFFICE My name is Dr. David Middaugh. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 Does a extruded medial meniscus towards the posterior root need surgery? Why would I? My calf swelled up into my ankles. That means that the remaining meniscus is smaller, but still taking the same pressure. 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. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. 4010 W. 65th St. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. 3 0 obj Your care after surgery may involve: Crutches to take stress off the knee as it heals. The Steadman Clinic - Edwards, CO Really cares for his patients! The following Tuesday, I saw my doctor. The exception is a patient that has contra-indications to surgery or already has too much cartilage wear and tear for the root repair to be beneficial. I went to Dr. Burnham for issues I was having with my shoulders. 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. Next, we performed biomechanical studies to show the effects of varying sizes of radial meniscus root tears, validating that a meniscus root tear within a centimeter of its attachment site functions as a meniscus root tear and can be treated the same. This can occur with turning, twisting, or pivoting activities or sports. With an injury like this you want the best, and Dr. Burnham is the best. Next, sutures are placed in the meniscal attachment and threaded through the hole in the tibia. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Also, I had to make numerous visits to the Ochsner Clinic due to my injury and Dr. Burnham's team and the staff at Ochsner were always very professional and courteous. The . This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. 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. Please help. You'll likely regain your previous muscle strength in the leg by. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. My pain was gone. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. 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. I had shoulder cuff repair, involving 2 ligaments & bone spurs, only 6 weeks ago. Please try again. (B) Posterior root lesion of lateral meniscus. Really a national leader in sports medicine! We currently use UltraTape to do this. Do minor meniscus tears require surgery or can it repair itself? 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. 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. How long did you have to avoid driving after meniscus surgery? Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. Healing kind of goes fast the beginning and then it tapers off. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. Proper fixation of the meniscal root can prevent or slow down the development of arthritis in that area of the knee. 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. Meniscus repair rehab protocol. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. A lateral meniscus root tear involves a tear of the meniscus either at or close to the root attachment in the back part of the lateral meniscus. 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. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. When I woke up I was in significant pain but the nurses had it under control by the time I left. United States. PT or exercise can be useful BUT take note of these the BoneSmart view on exercise BoneSmart philosophy for sensible post op therapy 5. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. They may start the use of a stationary bike, and may slowly wean off crutches starting at 6 weeks post-operatively. 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. And then they lose motion. 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 . 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. And they can get back to normal in about two or three months after having the surgery. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested. But theres still healing to be done and that 20% is really critical. The study included 351 patients with knee OA and meniscus tear. I am so glad I did! My daughter journey was very trying and hard but we made it through with all of their help. There can be many factors which can potentially cause pain after a meniscus root repair. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. The arthroscopic meniscus repair is a procedure done to repair torn knee cartilage, usually for athletes. PHONE: (952) 442-2163 | WEB: TCOMN.COM/PHYSICIANS/KYLE- MORGENSTERN/ . Had a meniscus root repair yesterday and the surgery was successful. He was outstanding. We had a wonderful experience and I highly recommend him. 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.