Meniscus Tear Specialist

Why repair the meniscus?  And why with the Circumferential Stitch?

Meniscus repair has been around a long time, but traditional techniques have had somewhat high failure rates and were only possible for a limited number of tear types. The meniscus spreads forces evenly within the knee joint, and, without its full function, the knee becomes arthritic.  

So why are we now able to sew every tear type in every age range?  Because we can now sew using Circumferential Stitches. These stitches…

• Line the tear edges up perfectly and uniformly compress them together during healing in a way never before possible
• Repair the top and bottom of the tear at the same time (traditional repair was only practical on the top side and surgeons typically ignored the bottom side which leads to partial healing and eventual re-tearing of the meniscus)
• Does not entrap the capsule during sewing which may allow more natural movement of the repaired meniscus
• The needle used in NovoStitch device is tiny and it cuts in-line with the circumferential fibers of the meniscus.  Other techniques have left large holes which can propagate new tears
• Passing the circumferential stitch does not require needle passes in the direction of the neurovascular structures
• There is no other device that can safely and reliably pass circumferential stitches in all zones of the meniscus and for all tear types

See the below video which shows how tears have been repaired in the past followed by how they are repaired with the NovoStitch! 

Am I too old to have my meniscus repaired?

NO! Studies have shown that patient age is not a factor, and that the meniscus can heal in patients of all ages provided the knee is not already arthritic

I was told my tear was “degenerative” and could not heal because there was not a good enough blood supply?

Traditional techniques inadequately approximated the torn edges, leading to poor healing. Surgeons often blame the blood supply even though there is excellent medical literature evidence that the avascpar zones heal if adequately held together during the healing process. See the videos on this site for additional proof!

See the following article, The Circumferential Compression Stitch for Meniscus Repair, for a better understanding of why repair your meniscus and to see the various tear types

What is a meniscus tear?

Your menisci are two wedge-shaped pieces of cartilage that cushion your knee joints and act as shock absorbers every time you take a step. While your menisci are critical to the long term health of your knee, any sudden twist or trauma can lead to a meniscus tear.  Without the full function of your meniscus, your knee joint becomes arthritic. The only definitive treatment for an arthritic knee is total knee replacement – so, SAVE YOUR MENISCUS!

Symptoms of a meniscus tear may include one or more of the following:

• Pain
• Limited range of motion in your knee
• Stiffness and swelling
• Feeling as though your knee is catching
• Locking or buckling
• Instability in your knee

You may still be able to walk after you tear your meniscus, and in fact, many athletes continue to play with a meniscal tear.

How are meniscal tears treated?

Leaving a torn meniscus within your knee increases your risk of arthritis and the eventual need for knee replacement surgery. Similarly, removal of part of your meniscus (often called “cleaning up”, “trimming” or “partial meniscectomy”) also results in significantly reduced effectiveness of your meniscus resulting in arthritis and the possible eventual need for total knee replacement surgery.

Injecting the knee with cortisone, PRP or even stem cells, has not been shown to heal meniscus tears. There are simply too many knee forces on a meniscus tear constantly pulling it apart, hence it cannot heal well without stitches holding the tear in place to resist those forces during the 6 weeks that it takes for the meniscus to heal (similar to a cast for a broken bone).

Assuming your knee is not already arthritic, your best option is to have your meniscus sewn back together rather than removed. However, traditional meniscus repair techniques only worked for a small fraction of the tear types, hence most orthopaedic surgeons have unfortunately embraced meniscus removal surgery which has been proven in the medical literature to be no better than doing no surgery at all at 6m and 2yrs out from surgery.

But now there’s a new option – THE CIRCUMFERENTIAL STITCH! This stitch anatomically aligns the tear edges and uniformly compresses them together during the healing process in a way never before possible. This is the secret sauce that Dr. Saliman brought to the world.

What is the NovoStitch Pro Meniscal Repair System?

Dr. Saliman invented the NovoStitch Pro Meniscal Repair System in 2008 and then founded the start-up Ceterix® Orthopaedics in 2010 to develop the technology. The NovoStitch was approved by the FDA in 2012, received a Silver Award in the 2015 Edison Awards in the surgical tools category, and was recently purchased by a well known medical device company called Smith & Nephew.

Dr. Saliman uses his NovoStitch device to place circumferential compression stitches around your torn meniscus, which holds the torn edges together while it heals. There is no need for removal of the tissue, which has been shown to increase the risk of future knee problems. Nobody has more experience sewing meniscus tears back together with circumferential stitches than Dr. Saliman.

For the best care of your meniscal tear from the inventor of the procedure that sews your meniscus with Circumferential Stitches, call the office of Justin D. Saliman, MD, or request an appointment online today.