A meniscus root tear occurs when one or both of these roots tear away from the 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. This mechanism of injury and the description of a pop is the classic description of one who has a meniscus root tear occur. The . The transtibial meniscal root repair is emerging as the gold standard treatment due to its ability to restore a large footprint at the meniscal root's native attachment site and restore normal joint contact pressures. 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. Unlike some meniscus tears which can be observed or treated conservatively, most meniscus root tears need surgery. 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. So if thats your feeling youve taken them and it hasnt really made a difference for you dont take them if you feel like to help you out please take them but dont just take the supplements in hopes of that replacing doing the right exercises and having the right expectations youve got to do them both together give us a like if you thought this video was helpful and please drop a comment if you have any questions and i hope that you get better real soon have a wonderful day guys. Dr. Nwachukwu and his team will have an individualized recovery program for the best healing success after your meniscal root repair. Rehabilitation begins within a week of surgery. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. And the good news is that it can be helped without another surgery. Very thorough, knowledgeable and courteous. Is this a tear? Very reassuring, showed me X-rays and explained the healing process very clearly. And now theyre kind of back to the way they were before the surgery. This technically challenging procedure should only be done by an orthopedic knee expert like Dr. Nwachukwu who has had extensive experience in performing the meniscal root tear repair correctly. Posterior horn medial meniscus root tears have been particularly noted to be a problem with a large number of patients developing arthritis rather quickly. This allows the meniscus to heal back to the bone. By far the best orthopedic team I have ever met. 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. 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. The roots of the meniscus are responsible for transmitting weight evenly across the surface of the tibia. Patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs can expect a variation of the following: Dr. Nwachukwu is extremely knowledgeable about his area of expertise. Very positive experience at Bone and Joint Clinic in Baton Rouge. 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. The root attachments of the posterior horns of the medial and lateral meniscus are very important for joint health. Therefore, the transtibial meniscus root repair technique is by far the most common procedure that is performed. As always, Dr. Burnham and his staff were caring, knowledgeable & professional at my recent visit. 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. And I feel my rode to recovery will be wonderful. After about five minutes, the wheels were spinning. Often the best medicine to take is NSAIDs like naproxen and ibuprofen. Therefore, we then looked at surgical techniques and due to the fact that we had multiple second look arthroscopies after bone grafting for ACL reconstructions with meniscus root tears, that the 1-tunnel technique had more of a spot welding healing of the meniscus to bone whereas the 2-tunnel meniscus root repair technique had a much better healing surface of the meniscus to bone. Thanks to Dr. Burnham and his staff. If a patient does have a meniscus root tear and the cartilage in that same compartment is still relatively good or normal, a meniscus root repair would be indicated. <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 12 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> I was referred to Dr. Burnham from my spine doc, Chambliss Harrod, MD and he turned out to be a way cool guy. There was absolutely no knee pain. Takes his time with you and doesn't hurry to rush out of the room if you have questions. Browse archives. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Swelling and stiffness. Thank you. We love you! 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. 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. The second step is to prepare a bony bed where the meniscus repair will be performed. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. This hoop stress is resisted by fibers that run circumferentially through the meniscus. It involves removal of some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (keyhole) surgery. Little information has been published regarding specific rehabilitation parameters for meniscal root repairs through all phases of rehabilitation. I did a few jungle gym rows, and finished with planks. They are connected to your tibia by meniscal roots. Meniscus Root Repair The most common method to fix meniscus root tears is through a tibial bone tunnel. Most root tears involve either a direct tear of the meniscus off bone or a split of the meniscus within 1 cm of the root attachment. I started Brazilian Jiu-Jitsu about four years ago. Realize that, as discussed above, the torn part of your meniscus was removed. Meniscus root repair is most commonly performed arthroscopically under regional anesthesia. while avoiding unnecessary surgery, injections, and medications. Dr. Burnham and Jerrica did a great job taking care of all my orthopedic needs. Dr. Burnham clearly cares about his patients and their follow up care. Contact Dr. Nwachukwus team today! It was glorious. Then I trained. They are also important to the stability and function of the knee, keeping the meniscus in place. If not treated, part of the meniscus may come loose and slip into the joint. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 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. The most common method to fix meniscus root tears is through a tibial bone tunnel. Kyle D. Morgenstern, MD . I also started boxing sessions once a week with one of my coaches as I am not allowed to start back to BJJ until September. And this channel is dedicated to helping people stay healthy, active and mobile. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Dr. Burnham was very personable and explained my situation in great detail. When I went in arthroscopically and thoroughly released the meniscus, pulling it back into an anatomic position and revising the repair; all of these patients seemed to have much improved pain relief. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. Meniscus Repair. Most of these types of injuries, that are symptomatic, require surgery. They moved my knee a bit, and I had decent ROM, better than expected. A written consent will be obtained from you after the surgical procedure has been explained in detail. The aftercare and recovery require postoperative protection to allow healing. Get answers from Family Physicians and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Non-anatomic root repairs do not restore normal joint biomechanics . 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. One should not look at age as a factor for meniscus root repairs. Deconditioning of ones quadriceps muscles can also cause similar symptoms, so it is important to determine if one has any atrophy of their thigh muscles, usually measured as the thigh circumference 15 cm above the patella and compared to the opposite leg. 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. Had a meniscus root repair yesterday and the surgery was successful. My name is Dr. David Middaugh. Tuesday: 8:00 am 5:00 pm Thus, these patients can often have early onset arthritis, the development of bony edema, insufficiency fractures, and the failure of concurrent cruciate ligament reconstruction grafts. 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. It is felt that most meniscus root tear repairs are sufficiently healed to start these activities between 5 and 7 months postoperatively. 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. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. His staff is very friendly and upbeat, knowledgeable and thorough. Are you an athlete who participates in sports that involve running and jumping? In addition, we looked at varying suture techniques through the meniscus, including 2 simple sutures, as well as other configurations of meniscus suture techniques, which are more complex. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Dr. Burnham and Jerrica are AMAZING! %PDF-1.5 importance of the meniscus root has become more apparent. Meniscus repair rehab protocol. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. He listens and address every concern with appropriate solutions. Matthias J. Feucht1,4 Received: 19 May 2022 / Accepted: 13 February 2023 It can be very difficult to interpret an MRI after a meniscus root repair. This can occur in up to 20% of patients, even in the best of circumstances. The most common root repair technique is called a transtibial technique. And cartilage is one of the slowest healing tissues in the body. 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. But youre also not alone. The general published success rate for a meniscus root repair is between 80% and 85%. Yet, if you feel discomfort, you can take over-the-counter pain medication. Oftentimes healthcare providers will tell you go walk your knees operated on its good youre the we took out the chunk that was you know causing your need to lock up the meniscus we did a meniscectomy or we repaired the meniscus and its all sewn together now so you can go ahead and walk all you want and some people take that to heart and to go walk you know three miles a day or even 10-20 miles a week and their meniscus just doesnt heal enough and they get that swelling. If it is the right knee, the average time until the patient is able to drive is 6-9 weeks. We had a wonderful experience and I highly recommend him. 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. It helps to be strong, my PT remarked. The Smith & Nephew root repair technique involves specific devices which can lower ones surgical time to perform a meniscus root repair. I am now adding 10 pounds a week to the bar for squats. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. In some instances, the meniscus posterior horn may need to be released from scar tissue to allow it to be repositioned. 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. While there are many factors that can go into extrusion, a maximum attempt should be made by the surgeon to try to pull the meniscus back in the joint to give the meniscus the best chance to function as a shock absorber after it heals. 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 torn meniscus is corrected via a minimally invasive procedure depending on the kind of injury. This is called decortication of the medial tibial plateau (for a medial meniscus root repair). I asked when I could start driving, and he said when I was off my pain medication. Therefore, addressing a meniscus root tear prior to the development of osteoarthritis would be indicated. Doctors typically provide answers within 24 hours. <> 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 . My daughter injured her ankle in cross country practice and we were able to get in the next day to see Dr. Burnham. They walked me through the process from beginning to end. 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. 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. very elderly patients). Medial Patellofemoral Ligament (MPFL) Reconstruction . To accomplish this goal, Dr. Nwachukwu drills a small hole from the outside of the tibia (shin bone) into the knee joint next to the natural attachment of the meniscus root. If you're an athlete needing a doctor that understands; this is the guy. Sit at home on the couch and watch T.V.? 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. Early weightbearing has been found to be the cause of meniscus root repair failure, and this has been validated by our colleagues In general, almost all meniscus root tears require a 6-week period of being nonweightbearing to maximize the healing potential. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. The Steadman Clinic - Edwards, CO The best surgeon is Baton Rouge that actually care about his patients!!! Your knee will be swollen. 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. A meniscus root repair involves reattaching the meniscus back to bone where it has been torn. The steps in a meniscus root repair are very intricate and our biomechanical studies have validated that the steps are essential.