driving after meniscus root repair

A sports medicine specialist will examine your knee and any relevant imaging to determine which treatment you should start with first. Healing kind of goes fast the beginning and then it tapers off. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. Ive already talked about this but I cant drive the point home enough if youve gone to the doctor. 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. EDINA- CROSSTOWN OFFICE In January of this year, I finally decided to go back to my doctor to get that MRI. But theres still healing to be done and that 20% is really critical. It hurt like hell. The knee will be swollen for 2-3 months. In general, one can follow the small tunnels from the transtibial technique up to where the root attachment should be. 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. The next day, my left knee blew up to the size of a grapefruit. It can be very difficult to interpret an MRI after a meniscus root repair. In particular, it is now recognized that the incidence of lateral meniscus root tears with an ACL tear is between 8% to 12%. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. And its really concerning and very disappointing for somebody whos gone through the knee surgery. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you b. Steadman Clinic, 181 W Meadow Drive, Suite 400, Vail, CO 81657, USA (email: drlaprade . Patients often report hearing a pop at the time of injury. 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. After about five minutes, the wheels were spinning. Usually, pain is minimal after this type of surgery. No swelling. What do you suggest if my MRI says that I have a horizontal tear in the body of the lateral meniscus is shown do I need surgery? Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation . Driving after meniscus root repair depends on which knee it is. Many tears have better outcomes if they are treated early. Therefore, we found that non-anatomic meniscus root tear repairs were not successful. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . Doctors typically provide answers within 24 hours. 1 0 obj 4010 W. 65th St. 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. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. In younger patients, meniscus root tears often occur with a piece of bone being avulsed off the tibia. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. <> The meniscus is a piece of cartilage in the knee, often injured in sports. 5 wks into recovery of acl/meniscus tear surgery, I am still taking pain medicine. It helps to be strong, my PT remarked. We had a wonderful experience and I highly recommend him. Regular assessment of gait to avoid compensatory patterns. 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. This hoop stress is resisted by fibers that run circumferentially through the meniscus. It is very important for proper healing, that the placement of the root matches the original Footprint or attachment site. (C, D) Arthrex MU (multiuse) guide with 6-mm FlipCutter drill positioned on footprint of posterior root of lateral meniscus. Is this a tear? Connect with a U.S. board-certified doctor by text or video anytime, anywhere. He listens and address every concern with appropriate solutions. Thanks to Dr. Burnham and his staff. It can also occur while bending the knee deeply. Phase I of Rehab: Surgery until 8 weeks. After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. <> Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. Timeline: 1 week to 5 weeks after Surgery. This technique allows one to place passing stiches up the cannula, which has significantly decreased the operative time. Synopsis There is a growing body of evidence surrounding the pathology and treatment of meniscal root tears. Contact Dr. Nwachukwus team today! In determining if one can have a revision root repair, one needs to determine the cause of the failure as well as the amount of underlying arthritis. . In radiologic terms, this is called a bony ossicle. The technique for a repair for a bony avulsion, called a type 5 meniscus root tear, is similar to the other techniques other than it should have the bone piece shaved down and cleaned off such that it can be pulled back into the area where it had been avulsed from. He had knee surgery a few months ago and is recovering remarkably well. Repairs have been found to delay or improve the findings of bony edema and the early onset of arthritis in many patients. You'll likely regain your previous muscle strength in the leg by. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again. 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. There goes my knee again.. Lateral meniscus root tears can lead to arthritis, but they also result in the ACL being a little looser and the clunk that comes with an ACL tear (pivot shift) being more unstable. But youre also not alone. The knee buckled and I thought, Shit. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. If you had a knee surgery if youve been seen physical therapy or any other health care professionals and theyre telling you youll be fine in three months back to normal youll be dancing youll be exercising youll be playing with the grandkids again just smile and remember this video. Meniscal repairs offer the benefit of preserving the native meniscus, but they require a longer rehabilitation protocol as compared to a meniscectomy. I kept training, modifying my squatting as needed until I could get back to proper depth. Instead of wall slides, I opted for high box squats. Thanks to his staff for being so helpful. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Arner, J.W., Herbst, E.. Meniscal Root Repair Article. 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. You may need surgery to restore full knee function. 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. And they can get back to normal in about two or three months after having the surgery. 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. A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. I hung on to this MRI referral for a good month or so, because the knee was starting to feel better, and I was still able to train and attend my BJJ classes. For these, please consult a doctor (virtually or in person). His extensive schooling, research, and commitment to his craft shined through at every turn as he evaluated my injury, presented all my options (clearly explaining non-surgical options and expected outcomes), and helped me plan my course of treatment and recovery. Your subscription could not be saved. There is often swelling of the knee and severe pain with walking, running, twisting, or moving the knee. In this technique, sutures are placed into the torn meniscus root and then shuttled down tunnels in the tibia to tie the repair into place. The Steadman Clinic - Edwards, CO Strength is one of the most important aspects of our lives. Dr. Burnham and his remarkable staff have been a godsend for our son. Really cares for his patients! 2018;47:762. Your care after surgery may involve: Crutches to take stress off the knee as it heals. If I could give more than 5 stars, I would. Request Case Review or Office Consultation, Lateral Patellotibial Ligament Reconstruction, Anatomic Analysis of the Posterior Root Attachments of the Menisci, Posterior Root Avulsion Fracture of the Medial Meniscus, Not Your Fathers (or Mothers) Meniscus Surgery, Anterior Intermeniscal Ligament of the Knee An Anatomical Study, Popliteomeniscal Fascial Tears Causing Symptomatic Lateral Compartment Knee Pain, Prospective Outcomes Study of Meniscal Allograft Transplantation. Stationary biking is allowed after 6-weeks with Dr. Nwachukwus approval and assessment of healing. You have two roots per meniscus which include anterior and posterior roots. Dr. Burnham is amazing. You may need to leave a message. 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. When I woke up I was in significant pain but the nurses had it under control by the time I left. Oct 24, 2020. It takes longer for a meniscus repair to heal than a meniscectomy. Two cannulas are subsequently placed into the area of bone that was decorticated to allow for the transtibial 2-tunnel technique to be performed. Specializes in Orthopedic Reconstructive Surgery. So that means youre good to go after two to three months. Thus, the entire weight of the body is transmitted through the femur into the cartilage of the knee. Dr. Burnham was very personable and explained my situation in great detail. The posterior roots are the most important as this is where a root tear occurs most commonly. I got rid of the box for squats the end of July. Super knowledgeable. The most common method to fix meniscus root tears is through a tibial bone tunnel. My pain was gone. And if youve never worked out your glutes if you went through physical therapy never really targeted your glutes ever you better start quick because chances are youve got a muscle imbalance thats caused extra pressures inside your knee thats led to that meniscus tear to begin with thats been the root problem and glute strength is what offsets that forces inside the knee so that your meniscus can heal all the way. There are 2 main variants of the transtibial root repair technique. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! I was very pleased seeing Dr. Burnham, however I was not pleased to learn I was expected to pay an additional co- pay within the same week to receive the results of my MRI. 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. Sit at home on the couch and watch T.V.? The technique of a meniscus root repair involves isolating the root, placing a minimum of 2 sutures in the remaining meniscal attachment, and trying to reposition it back to a more anatomic position. We love you! endobj Dr. Burnham has an awesome bedside manner. Medial meniscus root repair midterm results suggest excellent outcomes in a well-aligned knee with minimal degenerative change. I was cleared to drive at my followup appointment 2 weeks after surgery, which was exactly what my surgeon had told me to expect. By using our website, you consent to our use of cookies. 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. While regular functionality isn't immediate, patients will be asked to move the knee within 1-2 days after surgery. But typically physical therapy goes two to three months you get 80% better and a lot of times people have the expectation setting themselves that they can get back to everything that theyre doing before and thats just not the case they can do a lot of things now that they couldnt before the surgery typically. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. 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. Appreciate the attention and time spent during office visits. 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. 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. Medial Patellofemoral Ligament (MPFL) Reconstruction . 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. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. 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 ~. The American Journal of Sports Medicine. The results of meniscus root repairs in the literature are encouraging, but more improvement is necessary in the future. These are totally different. Dr. Robert F. LaPrade operated on my right knee in May of 2010. You can schedule an office consultation with Dr. LaPrade. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. Surgical repair can successfully allow the meniscus to heal. The back attachment of the medial meniscus, called a posterior horn attachment, is the most common location for meniscus root tears to occur. endobj stream Robert LaPrade, MD, PhD 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. Two weeks. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. 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. Patients \50 years had outcomes similar to those of patients !50 years, as did . Swelling and stiffness. This technique is fast and effective. My wait time for office visits has always been less than 10 minutes. The most common complication after a meniscus root repair is a re-tear. 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. 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. He spent a great amount of time explaining everything to me in a way that I understood everything. Tuesday: 8:00 am 5:00 pm On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. 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. Browse archives. Nothing. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. Dr. Burnham and Jerrica are AMAZING! Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 2700 Vikings Circle Meniscus root repair is a surgery performed to repair a torn meniscus root. 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. I highly recommend him. Historically, these root tears are often treated with benign neglect and either ignored or trimmed out. 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. Is this normal? He diagnosed the problem quickly and accurately. Dr. Burnham was very thorough with his examination and diagnosis. Please help. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. I would have relied strictly on physical therapy. Dr. Jeremy Burnham did a reconstruction of my ACL on April 19th. Grant H. Garcia, MD 148 subscribers Dr Garcia demonstrates his new meniscal extrusion technique to further improve meniscus root repairs. This is done to protect the repair and let the body heal it. My day is pretty much elevate the leg, ice the leg, do the exercises permitted twice a day. This allows the meniscus to heal back to the bone. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. I was adding 10 pounds a week for deadlifts but have now switched to pause deadlifts on Tuesday and add only 5 pounds a week to the heavy deadlift. The meniscus is a cushion of the knee joint. dressing in 48 hrs and may let them drive 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. One of the main portions of the system is a guide that can be placed inside the joint that fits around the tibial eminences and allows the surgeon to place the tip of the guide right at the area that has been decorticated of bone, where one wants to perform the root repair tunnel. I left my visit feeling very comfortable with where I was and what needed to happen next. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. I really like and appreciate the time and effort he commits to research. 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. And thats all good if youre going to end up having the surgery. If scar tissue is present, Dr. Nwachukwu will clean up the area so the knee is allowed to move through its entire range of motion. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. He provided a thorough explanation without wasting 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. Often, a patient will be placed into an unloader brace if they are bowlegged to take some of the stress off the healing repair. Proper fixation of the meniscal root can prevent or slow down the development of arthritis in that area of the knee. 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. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . Historically, most root tears were treated with meniscectomies because the importance of the meniscus root as a shock absorber was not well known. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. 4 0 obj 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. You can't walk right after surgery. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. 2 0 obj Many meniscus tears can be treated successfully without surgery. He then drills a hole from the front of the tibia, into the root area and brings the sutures through the hole in order to tie them together and hold the tissue in place. I have been walking and training normally for the past four and a half months.