Immediate and intense knee pain can signal a meniscus root tear, especially with pain at the back of the knee. They walked me through the process from beginning to end. Should a meniscus tear repair surgery be hurting 7 weeks post-operation? He listens and address every concern with appropriate solutions. Robert LaPrade, MD, PhD 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. I was going to rehab myself, and keep training as normally as I could. 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. Physical therapy exercises can help to improve muscle strength, knee range of motion, and decrease sensitivity to the pain. I did a few jungle gym rows, and finished with planks. Two weeks to the day, I got on my spin bike at the gym and did what I could do. 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. Dr. Burnham was very personable and explained my situation in great detail. The Steadman Clinic - Frisco, CO 226 Lusher Court Ste 101 Frisco, CO 80443. #JimmyWinkfield is 1 of 5 men to win the prestigious twitter.com/i/web/status/1, What are #loosebodies in the #hip? Highly recommended! I got rid of the box for squats the end of July. The High Tech Shirt Problem in the Squat Rusty Holcomb, Observations on Training by an Old Guy Phil Ringman. This usually presents with pain along the inside or medial portion of the joint and with swelling with activities. 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. My daughter recovered fully from a total knee reconstruction and now she able to return to sports. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. 28323545 Additionally, preparing 2 transtibial tunnels to secure the meniscal root to its attachment site further increases the Strength is one of the most important aspects of our lives. Everyone made us feel comfortable, and they were all polite and professional. Swelling and stiffness. It is shaped like a C and it serves to cushion and stabilize the knee. I chose not to use my crutches anymore. And they can get back to normal in about two or three months after having the surgery. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. very elderly patients). 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, https://www.epmanualphysicaltherapy.com/wp-content/uploads/2020/01/Logo-copy-1030x429.jpg, Shoulder Impingement: Everything You Need To Know To Get Healthy Again, Top 5 Shoulder Impingement Exercises To Help Get Healthy Again, Top 6 At Home Treatments To Begin To Naturally Heal Cervical Radiculopathy, Click Here To Schedule A Phone Call With An Expert, Click Here To Ask About Cost & Availability, Copyright 2022 - El Paso Manual Physical Therapy, How To Tell If Youve Got A Rotator Cuff Tear, Request A Virtual Visit With One Of Our Expert PTs, 28 day knee health and wellness boost program, 28-Day Knee Health & Wellness Boost Program, 28 Day Back Health & Wellness Boost Program. When the tear is examined during arthroscopy, Dr. Hess will decide if the tear is able to be repaired . short distances based on their motion and I would recommend his service to any recreational athlete. <> If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. When the meniscus root becomes detached, the meniscus can extrude out of the joint and lead to effectively having no functional meniscus. 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. <> And slowly, I started bending the knee more, and eventually took the box away from my bench. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. 4 0 obj So if youre sitting at home right now, and you just had your meniscus surgery a month or two ago, and youre thinking, gosh, why arent I much better already. I did a little internet searching, and diagnosed myself with a Bakers Cyst, which I discovered was pretty common with meniscus tears. In recent years the importance of the meniscus root has become more apparent. 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. The next step involves using a self-capture device to place either sutures or tape into the substance of the meniscus body. The study included 351 patients with knee OA and meniscus tear. So go check out that video on how to exercise your glutes theres five exercises in there that you can start doing them i would do them every day i do them a couple times a day even more if you can i would do what you can tolerate without it being too much soreness and your glute muscles and they should all generally be okay on your knee theres some where you got to kneel you can adjust it you can not do that exercise if you want. As a result, two weeks after surgery I was able to start driving my car, which is a manual. In general, in our practice, most patients who do have pain after a meniscus root repair fit into this category. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower . Factors Affecting Meniscus Tear Healing and Prognosis AOSSM Lecture from Jeremy Burnham, Ochsner-Andrews Sports Medicine Institute, Copyright 2022Jeremy Burnham, M.D. 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. 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. 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. Tuesday: 8:00 am 5:00 pm The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. Phase 1: 0-2 weeks post-operatively Goals Protect repair Minimize pain Minimize swelling . And get the pain under control and recover normally the way that you should have once you start doing the right things. Do minor meniscus tears require surgery or can it repair itself? Two important criteria exist to begin driving after meniscus surgery. I have two good arms, and a good leg. In addition, the design of the meniscus is such that the full pressure of weight bearing activities is transmitted through the root of the meniscus, meaning that it is constantly pulling and stretching the tear with every step. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. Two weeks today I had meniscus root repair. Very thorough, knowledgeable and courteous. United States. His interaction with me around my surgery calmed me, and his excellent work in the operating room speaks for itself. Your knee will be swollen. The most common method to fix meniscus root tears is through a tibial bone tunnel. Dr. Burnham has an awesome bedside manner. (Please keep reading below for more information on this treatment.). Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. If you think you may have a meniscus tear, it is recommended that you see a sports medicine physician as soon as possible. According to a new study, it is safe for patients who underwent rotator cuff repair to safely return to driving two weeks after surgery. 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. In addition, there is no low age for meniscus repairs, with some root repairs being done in patients as young as 6 or 7 years old. 2018;47:762. For this reasons, it is crucial to identifiy and treat meniscal root tears in a timely manner. They are connected to your tibia by meniscal roots. A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee. 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. These radial root tears are equivalent to a meniscus root tear. Really cares for his patients! A meniscal repair is a keyhole surgery technique for repairing a ripped meniscus.. He was outstanding. Created for people with ongoing healthcare needs but benefits everyone. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. This answers all my questions! My daughter journey was very trying and hard but we made it through with all of their help. It was tough, and it hurt like hell, but I took it slowly. Meniscus root tears are now being recognised as a significant cause of pain, disability, and rapid joint deterioration. At the beginning of April, I was dancing at a friends wedding when I suddenly heard and felt a loud pop in my left knee. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. 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. Oct 24, 2020. When you put weight on your leg, it is the meniscal roots that transfer the axial loading forces of the knee into hoop stress in the meniscus. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Dr. Burnham & his staff are very personable & caring. 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. Now, the focus when you go into a surgeons office, theyre looking at your MRI, theyre looking at your meniscus on the MRI, theyre telling you the tear in the way that its torn and how theyre going to repair it. When I returned home around 1pm that day, I sat in my living room for a bit, emailing and texting people to let them know I was alive and well. Country. I decided to continue with my usual four day split with two upper body days and two lower body days, although I did also incorporate a few extra upper body exercises as my lower body work was not that intense. My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. The second step is to prepare a bony bed where the meniscus repair will be performed. General anesthesia and a nerve block. What made my recovery so fast? There are 2 main variants of the transtibial root repair technique. 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. Realize that, as discussed above, the torn part of your meniscus was removed. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. drive the next day if they feel ok. I continued to lower the box for squats, and started to add weight. And Im a specialist physical therapist El Paso manual physical therapy. 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. My name is Dr. David Middaugh. He made my daughter feel comfortable and made sure to listen to both of our concerns prior to his diagnosis. Conservative treatment methods are typically reserved for patients who would not recover well with surgery (i.e. Strength. He provided a thorough explanation without wasting time. Other complications can include a blood clot, which is usually treated preemptively with some type of blood thinner, and irritation around the surgical button and/or surgical knot from the meniscus root tear. Meniscus root repair is a surgery performed to repair a torn meniscus root. Meniscal root avulsions are a challenging injury causing meniscal extrusion and loss of hoop stress distribution, which can lead to the development of knee arthritis.1 Securing the meniscus in a small bone socket has proven to be an effective means to restore hoop stresses and improve outcomes.2 The FlipCutter II reamer and meniscal root marking hook allow for a minimally invasive . If the meniscus is extruded, the patient may not be having a restoration of their shock-absorbing capacity of the meniscus. Amazing doctor, amazing family mantreats patients with the highest level of care, compassion, and quality! There can be many factors which can potentially cause pain after a meniscus root repair. 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. We have published on several of these, noting that a PCL tunnel which is placed too close to the joint can detach the posterior horn of the medial meniscus and lead to the development of arthritis of the medial compartment. 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. So its important at the very beginning its appropriate at the very beginning to make sure that all your emotions back and that you can do some simple walking to and from the house even though hurts so that youre not you know having accidents and better so youre not having emergencies happening you need the function of your leg back. Repetitive motions, overuse, and muscular imbalances ar twitter.com/i/web/status/1, Digging Deeper into the Data: Is Suture Bridge Repair + #PRP really the best technique for #rotatorcuffrepair? twitter.com/i/web/status/1, Wild Life of the Last #BlackJockey to Rule the #KentuckyDerby There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. Timeline: 1 week to 5 weeks after Surgery. These UltraTape or sutures can then ultimately be shuttled down the cannulas and then tied over a metal button on the front part of the tibia. (it is still a bit swollen). You can schedule an office consultation with Dr. LaPrade. 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. I finally decided to make an appointment with a knee specialist. After about five minutes, the wheels were spinning. To learn more, please visit our, If it is your left knee, you can probably drive very shortly after. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. His staff is very friendly and upbeat, knowledgeable and thorough. endobj 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. Medial Patellofemoral Ligament (MPFL) Reconstruction . I was told it would be about 6 weeks, but my instructions are to wear a brace at full extension for the duration of this time. (B) Posterior root lesion of lateral meniscus. Oftentimes, after having a meniscus surgery, people are told that they'll be fine. Wednesday: 8:00 am 5:00 pm I sat down and put together a training program with exercises I could do, and trained four days a week as normal. A meniscus root tear requires the meniscus to be repaired back to the lower leg bone; this is also performed arthroscopically. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. Doctor Burnham and his staff were so helpful providing all the pros and cons associated with having surgery. Dr. Burnham performed my hip pin surgery and it all went extremely well. 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. As surgical techniques are being developed and refined, rehabilitation protocols for meniscal root repairs must be defined and tested.