Repeat lateral meniscus surgery is indicated 14% of the time due to continued impact on activity. Next, we’ll have to improve the strength of your … Over the years, there has been lots of confusion about when to operate on a meniscus tear. https://www.ncbi.nlm.nih.gov/books/NBK519494/, https://pubmed.ncbi.nlm.nih.gov/12594567/, https://medlineplus.gov/ency/patientinstructions/000684.htm, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389077/, https://www.ncbi.nlm.nih.gov/books/NBK470549/, https://clinicaltrials.gov/ct2/show/NCT03059004, https://www.arthritis-health.com/surgery/knee-surgery/types-knee-surgery-arthritis-treatment, Prepatellar Bursitis or Beat Knee or Carpet Layer’s Knee: Signs, Causes, Treatment, Synovial Plica Irritation: Symptoms, Prevention, Treatment- PT, NSAIDs, Surgery, Dietary Do’s and Don’ts for Migraine Sufferers, Shirshasana (Headstand) Versus Inversion Therapy Using Inversion Table, Understanding Joint Pain and Tips to Get Relief Using Home Remedies, Erectile Dysfunction: Does Opioid Cause ED, Libido: Opioid Induced Female Sexual Dysfunction. We remember in our youth that aches and pains subsided in days. The cherry on top is the height that Zion gets on his jumps which further serves to significantly increase the force of landing. Mild amount of exercises is done for maintenance of the quadriceps strength, although if they exacerbate the symptoms then they should not be done. Additionally, Zion went from multiple months without focusing on … Pain or an audible click during this maneuver signifies a tear of the medial meniscus. The medial knee joint is larger and more stable because the outwardly rounded (convex) femur (thigh bone) sits neatly into the inwardly rounded (concave) tibia (shin bone). • Extension ROM equal to contra lateral side PHASE III: LATE POST-OP (6-8 WEEKS AFTER SURGERY) Rehabilitation Goals • Continue to protect repair • Maintain full extension • Normalize gait • Flexion within 10 degrees It’s certainly plausible that these issues could’ve to Zion favoring that left side and compensating with increased loading on his right leg and knee. scar tissue?" In contrast, landing on the mid-foot with knees flexed (bent) only creates a GRF that’s roughly 3x your body weight with most of the force attenuated by muscles rather than joints. They can tear due to degeneration, or they can tear due to trauma or a sports injury. Surgery is performed to repair meniscal tear using arthroscope. Activity load fluctuations. The integrity of the meniscus was classified at surgery. Over time and reps, that increased stress - even if slight - can lead to downstream injury. Regarding this, how painful is a lateral meniscus tear? Prescribed for muscle spasm and improved joint movement, Most common muscle relaxant prescribed are skelaxin, robaxin and flexeril. In general, because of the important shock-absorbing ability of the Quad Exercises. These cartilages can be damaged or injured as a result of twisting injury or certain other forms of injury. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers. Those suffering from a lateral meniscus injury will also usually experience increased pain symptoms when bending the knee or with squatting down. A meniscal tear is a tear in the cartilages, or menisci, that are located between the two bones that make up your leg. In general, if you are over 30 years old the meniscus has reduced healing potential and is less likely to be repaired as the blood supply to your meniscus starts to diminish. And symptoms, if any, might In line with that, the Pelicans have given a 6-8 week return timeline for Zion, which conservatively means he’ll be back by mid-December. Wearing a knee sup… Lateral meniscus debridements are concerning for elite athletes because they can lead to arthritic changes in the knee in less than five years whereas those changes may not be seen after a medial meniscectomy for upwards of 20 years. This convex-concave bony relationship is akin to a ball sitting into a cup. This is really difficult to tell from game tape alone but the team can do a running gait analysis to check Zion’s typical running stride for stride length and then correct as needed. Gentle exercises to maintain quadriceps muscle strength in the thigh can be done, although care should be taken not to aggravate the symptoms. … This article on Epainassist.com has been reviewed by a medical professional, as well as checked for facts, to assure the readers the best possible accuracy. The procedure involves suturing of the torn cartilage. This is the trifecta of landing injury risk because it creates a huge shock wave of ground reaction force (GRF) upwards, with research showing a force upwards of 7x your bodyweight that is primarily absorbed by the joints because the muscles - the body’s primary shock absorbers - are placed in a very disadvantageous position. Kindle Version   $34.95  $8.99      Buy Now The patient is positioned on the front with knee flexed. The only meniscal tears that need surgery are those that can be repaired, or tears that give persistent pain despite good quality non-operative care. The lateral meniscus is also less anchored to the shin bone (tibia), making it a free floating pad of cartilage between your thigh and shin bones (femur and tibia). Fool me once, shame on you. Lateral menisci injury is observed following abrupt twist, direct impact and in elderly patient secondary to degenerative knee joint disease. Consultation with a sports injury specialist. Patients who are younger and fitter have better results. Arthroscopic total meniscectomy — Occasionally, a large tear of the outer meniscus can best be treated by arthroscopic total meniscectomy, a procedure in which the entire meniscus is removed. However, I haven’t seen much, if any, of that pattern carry over to the game. To that point, meniscus injuries are like real estate - it’s all about location location location. In cases of an unstable knee, use of a knee brace or support. In fact, you might not realize you’ve torn your meniscus when it happens. Arthroscopic view of a traumatic posterior horn medial meniscus root tear avulsion is shown. Severe pain is localized over lateral area of the joints of the knee. Get To Know What Possibly Could Be Causing Your Symptoms! Meniscus tears can be treated by meniscus removal (meniscectomy), meniscus repair, or in unusual circumstances, meniscus replacement. As you move from the outer (peripheral) part of the meniscus to the inner (central) part of the meniscus, there’s less and less and blood supply - schematically represented as red, pink, and white zones. For example, Steph Curry displays significant knee valgus on his jumper but that doesn’t translate to other in game jumps or his walking gait. Many people do not understand why many meniscus tears do not require surgery. The injury of lateral menisci is less common than medial menisci or cartilage. If the tear isn't a good candidate fo… Policy. In these cases, surgery may be indicated to ensure an optimal outcome. There are four options for torn meniscus surgery: Arthroscopic meniscus repair to stitch (suture) the torn meniscus back together This article does not provide medical advice. Key points This article may contains scientific references. Cartilage thus protect the bones and soft tissue within the knee joint.[1]. On the smaller, less stable, higher sheer force lateral side, the meniscus serves to help mitigate each of these aspects - providing stability while increasing joint surface area to help distribute and absorb the higher stress of the shear forces. Further, a key part of Zion’s game is using jarring lateral jump stops and hard pivot rotations. If you prefer video, I’ve got you covered as well: The meniscus is a dual-crescent shaped, force absorbing, friction reducing piece of cartilage that sits between the femur (thigh bone) and tibia (shin bone) within the knee joint. Indicated for severe meniscal tears such as a bucket handle tear. They concluded: “Arthroscopic partial meniscectomy was associated with a slightly increased risk of developing radiographic knee osteoarthritis and no concomitant benefit in patient-relevant outcomes, at five years after surgery.” but i was doing a squat and felt popping right there could i have torn my meniscus?" Bucket Handle Tear. Indicated for severe meniscal tears such as a bucket handle tear. At one month the average patient is 80% back to their pre-tear activities and sports, and 90-95% at two months. Unfortunately, we’ve seen this before from Zion. Surgical Treatment for Tear of the Lateral Meniscus (Cartilage): Arthroscopic Surgical Repair for Lateral Meniscus Tear- Surgery is performed to repair meniscal tear using arthroscope. Lateral menisci can be damaged or injured as a result of twisting injury or certain other forms of injury. Answered by Dr. Ronald Quam: Meniscal tear postop: It could very well be scar tissue. I will say it’s not uncommon to see players move differently in game than outside of the game or even on similar in-game movements. In this piece, I’ll explain the injury, the procedure, five potential underlying causes for the injury, and why it’s a serious issue moving forward. Find a Physician                            Privacy Policy, Images and Text Policy                Editorial Policy, Information Policy                        Advertising Policy, Financial Disclosure Policy          Cookie Policy, About Us                                        Contact Us. It's sometimes possible to repair a torn meniscus, especially in children and young adults. Surgery can be used to stabilize some meniscus tears. Overall, there’s a distinct possibility in my opinion that one, some, or all of these factors may have contributed to the lateral meniscus tear and subsequent need for debridement. That stark contrast is due to anatomical and biomechanical differences between the lateral (outer) and medial (inner) compartments of the knee joint, respectively. These large jumps in activity are a key risk factor for soft tissue (muscle, cartilage, ligament, tendon, bone) injury and, to that point, one of the main standards of sports performance and injury prevention is a formula called the acute:chronic workload ratio which looks at your current level of activity (acute) compared to your overall level of activity (chronic). Studying the film, Zion likes to land on one leg with his knee extended, occasionally on his heel. A small or degenerative tear will most likely be treated with conservative treatments such as ice, anti-inflammatory medications, compression, and potentially a knee brace. Additionally, new Pelicans GM David Griffin also admitted that Zion wasn’t in good shape, particularly from a cardiovascular conditioning standpoint. Both the cartilages are replaced with artificial prosthesis. That’s why removing a piece of the lateral meniscus can lead to potentially devastating changes in the knee. The main aim of this surgery is to salvage the meniscal cartilage as much as possible. Over-striding puts excess stress on the lower body because it typically means you’re striking the ground with your heel with your knee extended which - as we already discussed with landing mechanics - increases ground reaction force (GRF) and stress through the joint. The repair is only an option when the tear occurs in a part of the meniscus that is vascularized, meaning it has blood supply. Advertisement PDF Version   $34.95      $8.99      Buy Now Lateral meniscus is replaced with artificial prosthesis. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling. Does a Meniscus Tear Need Surgery? explains and performs a Knee Arthroscopy for a meniscus tear.A range of knee inj... http://osicda.comhttp://orthopedicsportsinstitute.comDr. If it produces any symptoms of pain or a click, then the test is termed as positive signifying a tear of the meniscus. Ask around and you will probably find a few peers or colleagues that have experienced a meniscus tear. Patients use crutches for 1-2 days, and are able to return to their everyday activities within one week. Proprioception exercises help in increasing the balance and sense of joint positioning. This characteristics remind me of Blake Griffin earlier in his career where he was very liberal with his use of athleticism and explosiveness, leading to a plethora of high risk situations. Surgery for torn meniscus may be necessary if your doctor feels that the tear will not heal on its own or you need your knee to heal more quickly and securely than it might with non-surgical treatment. However, that didn’t seem to be the case with Zion as he looked noticeably less defined and rotund when he showed up for summer league. At the least, it’s a serious wake-up call for addressing those potential underlying causes and could prove to be a catalyst in Zion taking a more consistent and long-term approach to his health and fitness. The second possible bio-mechanical factor is running mechanics. If that doesn’t work, consider lateral meniscus tear surgery alternatives and biologic therapies like platelet rich plasma or stem cells before you consider letting someone whack out a part of your meniscus. Pain when pressing down on the knee (prone position). "i had arthroscopic knee surgery to fix a lateral meniscus tear. Paperback   $74.95         $24.95    Buy Now, Advertisement Kindle Version  $6.99      Buy Now. I’ve been concerned about Zion’s movement patterns and mechanics since I saw him in high school, primarily his landing mechanics. Audible popping, cracking or clicking sounds heard during knee joint movement. In case of a suspicion of a meniscal tear, this test is done. Other modalities of PT are as follows-. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Lower Body, Athlete Injury, american football, stress reaction, injury, rehab, manchester united. Since the goal of surgery is to preserve healthy meniscus, meniscus repair is attempted Your doctor will also take into account your age, your activity level, and any other health issues you may have. Typically, this lateral shift during stance phase can be indicative of weak hip abductors - primarily the gluteus medius - and/or muscle tightness on the outside of the hip, particularly the tensor fascia latae (TFL). New Orleans Pelicans #1 draft pick and much anticipated rookie phenom Zion Williamson has been diagnosed with a right knee lateral meniscus tear that required surgical debridement. If the tear can't be repaired, the meniscus might be surgically trimmed, possibly thr… Bruises and purple discoloration may be seen following traumatic injury. This article does not have the information I am looking for. Surgery is less extensive than total knee replacement. Meniscus tear treatment: sham surgery This study actually followed their surgery vs. sham patients out to 5 years. A bucket handle tear is similar to a horizontal tear, but this type of tear … i still have pain when i completely straighten my leg. Glucosamine/joint healing supplement should be taken. The therapist holds the heel and ankle and puts force to the lower part of the leg. Improve the strength of your leg muscles. That’s nearly impossible to answer without further assessment. Well, those days are long gone. Increased temperature of the skin over the joint suggests signs of inflammation. A great product for this is use of a wobble board. The function of the cartilages is to absorb abrupt pressure change resulting in shock. If there is swelling PRICE principles should be applied (protection, rest, ice, compression, and elevation). Fool me twice... Additionally, Zion went from multiple months without focusing on his fitness after Duke’s tournament exit in March to playing one game in summer league to then participating in camp and playing in multiple pre-season games, with a Pelicans team that plays at a really high pace and running quantity. Accordingly, the meniscus on the lateral side plays a substantially different role than it does on the medial side. If your knee remains painful despite rehabilitative therapy or if your knee locks, your doctor might recommend surgery. Thanks for reading. Although many meniscus’s tears don’t require surgery, the Pelicans medical staff decided surgery was the best option moving forward. A large bucket handle tear on the periphery of the meniscus would be more amenable to repair than a smaller tear that sits centrally. The current research on this topic is evident. Swelling is observed over lateral side of knee joint. Most large meniscal tears, particularly involving a locked knee also require surgical intervention. The research shows that the average RTP timeline for elite athletes after a repair is 5.6 months whereas the average RTP after a  debridement is six weeks. Symptoms of a lateral meniscus tear may include tenderness and pain around the outside surface of the knee, particularly along the joint line. This article contains incorrect information. At the same instance, the lower part of the leg is rotated. The treatment of a meniscus tear will depend on the type of tear you have, whether or not you also have osteoarthritis and the nature of your complaints. Prescribed for inflammation and pain relief, Most common NSAIDs prescribed for lateral meniscus tear are Motrin, Celebrex and Daypro. Meniscus Surgery: Recovery Time Topic Overview Surgery to repair a torn meniscus involves rehabilitation, although it varies depending on the injury, the type of surgery, and your orthopedist's preference. Per the Pelicans official statement, Zion had the former. Most common opioid prescribed is hydrocodone or oxycodone. The first is a traumatic tear … Physical condition of the patient. The majority of people with knee pain and degenerative meniscus tears have a great chance of responding to physical therapy alone. To that point, his former coach, Coach K, said that Zion shouldn’t have played in the summer league at all because he wasn’t in physical - or mental - game shape. That’s a wrap for this piece. Surgery for a lateral meniscus tear involves a Age of the patient and associated degenerative knee joint disease. Treatment for a lateral meniscus tear would initially be conservative meaning the athlete would try the easy simple things first including rest. Relieving meniscal tear symptoms: surgery vs. other methods Not everyone with a degenerative meniscal tear has symptoms. It’s a lesson that Zion will have to master as well. Swelling is observed after couple of days following the injury. The feedback link “Was this Article Helpful” on this page can be used to report content that is not accurate, up-to-date or questionable in any manner. An inward stress is then applied on the knee and the leg is externally rotated with the other hand and the knee is extended. Mild mobility exercises and stretches should be started to regain full knee range of motion. Surgery is generally necessary to repair a torn meniscus only if the tear is unstable, you have healthy meniscus tissue, and the tear is in an area of good blood supply. The Make sure to subscribe to the YouTube channel and the blog for the latest updates. Lateral cartilages of knee joint lies on outer half between femur and tibia bone. Shock absorption prevents rapid wear and tear by abrupt change of force. Prognostic factors for good outcomes following surgery include which meniscus is involved, the size of the tear, amount of tissue resected , age, and cartilage health. The question becomes is his walking gait pattern more of a neuromuscular habit or can we attribute it to some functional deficit? Your quadriceps muscle is very involved in your knee flexibility and stability. In Zion’s case, we can only hope that the piece of irritated and debrided meniscus is relatively small so as to only mildly disrupt the biology and function of the lateral meniscus and thus reduce the chances and rate of arthritic changes. 3CB out. Supervised exercise to strengthen muscle and ligament strengths. If the torn meniscus is healthy tissue with a good blood supply, then surgery to stabilize the tear may allow for healing. Answered by Dr. Edward Hellman: Yes: Yes, it is possible that you tore your Majority of meniscus tears do not need surgery. A lateral meniscus tear is different from a medial meniscus tear because the lateral meniscus carries up to 70% of the weight and contact pressures in the lateral capsule of the knee. Zion is an incredibly high energy, high activity player - which when paired with his elite athleticism and drive, makes him such a unique prospect - but it also leads to him playing with a reckless abandon that too often puts him into high risk situations. Range of motion of the knee joint is reduced. In a period of 6 months, Zion had two insults to his left knee - a grade 1 MCL tear at Duke and knee to knee contact during game 1 of the summer league that kept him out the remainder of the tournament. The knee joint is protected by two hemispherical-shaped cartilage known as menisci. Our articles are resourced from reputable online pages. If you have a tear in the white zone of the meniscus, repair surgery usually isn't done, because the meniscus may not heal. Meniscus surgery is used to repair or removed the damaged tissue. Jeffrey Lyman, M.D. There are two surgical options for meniscal tears: Removing the damaged cartilage - known as a meniscectomy or debridement - or repairing the damaged cartilage - known as a meniscal repair. "i had surgery for a medial and lateral meniscus tear 4 months ago. One half sits on the inner (medial) aspect of the knee and the other sits on the outer (lateral) aspect of the knee. The knee is held up and protected by two hemispherical-shaped cartilage menisci present in the knee joint. The majority of you will not require surgery. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. There’s been considerable talk about Zion’s weight and how that contributed to his injury. Gaining weight - in and of itself - isn’t an issue when it’s done methodically to build lean muscle and a leaner body composition. A rehabilitation program needs to be followed religiously postsurgery comprising of strengthening and balance training so as to hasten the recovery. I’m not saying Zion will share Rose’s injury history but these movements aren’t the easiest on your body, especially when done repeatedly over time. (LFC, lateral femoral condyle; LM, lateral meniscus; LMR, lateral meniscal root; LTP, lateral tibial plateau.) For medial meniscal radial root tear repair, viewing and device entry can be achieved from either aforementioned portal with the knee in 20° of flexion with a … My goal is to provide you with in-depth, evidence based, narrative free analysis and you can always find me on IG and Twitter @3CBPerformance. So if you have a lateral meniscus tear, look at physical therapy first. Meniscus tears that are cut out through debridement have a much shorter recovery time than those that are repaired with stitches. Patients were grouped as either untreated injury to LMPR WST “with stable tear” group (n=52), or intact lateral meniscus NT “no tear” group (n=440). Pain is severe with knee joint movements. If this approach doesnt work then a doctor may recommend surgery. Meniscus tears are one of the most common knee injuries. In clinical practise, a small percentage of minor meniscal injuries fail to improve adequately despite appropriate physiotherapy treatment. Repaired tissue cannot heal without blood flow. Treating a Lateral Meniscus Tear Depending on the size and severity of the tear, your physician will help you determine whether to proceed with conservative treatment or surgical intervention. Test- The physician will then hold the knee with one hand and the heel with the other. Images: Krych AJ There are two types of meniscal root tears. Among the things most people can expect from meniscus surgery are small incisions, the use of a small camera to see inside the knee and the use of a general Thirdly, I’ve seen and heard commentary on the way he walks and how that could be contributing to the knee problem. When the chronic level of training has either underworked or overworked an athlete relative to their current level, the research shows a 7x increase in soft tissue injuries. All in all, this is a concerning injury for Zion due to the functional importance of the lateral meniscus, the future risk associated with lateral meniscectomies and inherent risks that come with his current playing and movement style. On the other hand, the lateral side of the knee joint is smaller and less stable because both the femur and tibia are convex (outwardly rounded) - like a ball sitting on another ball - with increased translation (movement) and higher shear forces along that side of the joint. During his 2017 summer stint with USA basketball, the very reliable and astute Jonathan Givony and Mike Schmitz noted that Zion looked  “heavy and out of shape”. Once the pain has reduced, strengthening exercises for the thigh and calf muscles should be started.

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