Radial Meniscus Tear Specialist

Why repair a radial meniscus tear?  And why with the Circumferential Stitch?

Meniscus repair for radial tears has been around a long time, but traditional techniques have had high failure rates. The meniscus spreads forces evenly within the knee joint and with a radial tear it loses its function, causing the knee to become arthritic over time.

So why are we now able to sew radial tears back together?  Because we can now sew directly side-to-side using Circumferential Stitches.  These stitches…

• Line the radial tear edges up perfectly and uniformly compress them together during healing in a way never before possible
• This means true side-to-side compression of the tear surfaces (rather than side-to-back that is done with other techniques)
• 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)
• Do not entrap the capsule which may allow the meniscus to have a more natural movement within the knee
• The needle used in NovoStitch device is small and it cuts in-line with the circumferential fibers of the meniscus.  Other techniques have left quite large holes in the meniscus which can in themselves propagate new radial tears
• Passing the circumferential stitch does not require needle passes toward neurovascular structures
• There is no other device that can safely and reliably pass circumferential stitches in every zone of the meniscus

Am I too old to have my meniscus repaired?

NO!  Studies have proven 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 that radial tears did 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 despite excellent medical literature evidence that the avascular zones heal if adequately held together during the healing process.  Side-to-side repair of the top and bottom of the tear are key to successful repair!

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 radial meniscal tear?

A radial tear is one of the most catastrophic types of meniscus tears in terms of likelihood for arthritis later in life.  It is a tear across the C-shaped surface of the meniscus in a manner that effectively divides it into two non-functional sections.  With radial tears, in particular, the meniscus is rendered functionless and can no longer absorb the hoop stresses that distribute forces in the knee.  Radial tears left torn or treated with partial meniscectomy (often called “trimming” or “cleaning up”) lead to an arthritic change of the surrounding articular cartilage within the knee.  The only definitive treatment for an arthritic knee is total knee replacement – so, SAVE YOUR MENISCUS!

Symptoms of a radial meniscus tear may include:

• Significant pain
• Limited motion
• Swelling
• Stiffness
• Feeling as though your knee is
• Catching
• Locking
• Buckling
• Unstable

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

How are radial meniscal tears treated?

Leaving a radial tear in your meniscus increases your risk of arthritis and the eventual need for knee replacement surgery.  Similarly, removal of the radial tear (often called “trimming” or “partial meniscectomy”) also results in a significantly reduced effectiveness of your meniscus resulting in arthritis and the possible eventual need for total knee replacement.  Injecting a radial tear with cortisone, PRP or even stem cells, has not been shown to heal meniscus tears. There are simply too many knee forces on a radial meniscus tear (the forces are constantly pulling the radial tear apart with every step and with bending of the knee).  Hence, it cannot heal well without side-to-side 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).

Your best option is to have your radial meniscus tear 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.  But now there’s a new option – THE CIRCUMFERENTIAL STITCH! This stitch anatomically aligns radial 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 an Edison Award in 2015 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 stitches around radial meniscus tears to hold the torn edges together during healing. 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 meniscus 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.