An improved surgical technique used for years in Cincinnati may help thousands of young people nationwide avoid joint replacement operations years after serious knee injuries.

        Dr. Frank Noyes, an orthopedic surgeon with Cincinnati Sportsmedicine and Orthopaedic Center, is expected to present findings today showing high rates of success for surgeons who repair complex tears in the meniscus, a tissue in the knee that acts as a shock absorber. He is expected to speak at the annual American Academy of Orthopaedic Surgeons convention in San Francisco.

        Repairing rather than removing the donut-shaped meniscus means people in their 20s and 30's won't need knees replaced so soon.

        “This is good news for our young patients to save their knees,” he said.

        “We've been doing these repairs for 15 years now. We believe at least double the amount of repairs could be performed. That represents thousands and thousands of

        cases.”

        Meniscal tears are common, but serious, knee injuries. They usually happen during soccer, volleyball and other activities.

        Surgeons usually treat this injury by removing the meniscus.

        According to the academy of orthopedic surgeons, nearly 500,000 meniscal excisions occurred in 1996, including 28,000 on youths age 9 to 19. Many of those patients then suffer severe arthritis in the knee about 10 to 15 years later and usually require joint replacement surgery.

        Since 1983, Dr. Noyes has followed 61 people, ages nine to 19, who received complex meniscal repairs four years ago or longer. Of those, 75 percent still have healthy, pain-free knees.

        That's better than meniscus transplants, which are more expensive and have a 50 to 70 percent rate of success, Dr. Noyes said.

        “I hope these findings will prompt more surgeons to aggressively attempt meniscal repair instead of meniscal excision,” he said.

        The technique, performed by Dr. Noyes and a few other surgeons nationwide, involves making 16 to 20 sutures to close tears, which previously may have gotten four or five stitches, if any. The tighter suturing appears to make it easier for the damaged meniscus to re-grow tiny blood vessels to heal.

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