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About Dr. Steven Meier
About Dr. Meier
Trusted Orthopedic Surgeon in Beverly Hills
Dr. Meier’s story begins in the Chicago area, where he grew up and attended Elmhurst College for his unde`rgraduate studies. He then enrolled in medical school at Loyola University Chicago and obtained his medical degree in 1993. After deciding to specialize in musculoskeletal care, Dr. Meier then matched into his first-choice orthopedic surgery residency program at Northwestern University. After completing the 5-year residency program studying the surgical and non-surgical treatment of conditions affecting the spine and extremities, he went on to complete a sports medicine fellowship at the University of California San Diego focused primarily on shoulder and knee surgery. After completing formal training in 1999, Dr. Meier returned to his hometown to enter private practice on Chicago’s North Shore. After two years there, he came upon an opportunity to combine clinical practice and research in a university-affiliated private practice in northern New Jersey. There Dr. Meier advanced his surgical techniques while concurrently performing biomechanical research at the University of Medicine and Dentistry of New Jersey in Newark. After four years on the East Coast, Dr. Meier accepted the position of Assistant Clinical Professor at the University of California Irvine in 2006, where he continued to refine his surgical techniques while teaching surgeons-in-training. Then, in 2010, Dr. Meier finally achieved his long-time goal of establishing his own private clinic and founded Meier Orthopedic Sports Medicine in Beverly Hills, California.
In the late 1990s, a series of research studies on rotator cuff surgery of the shoulder were published using postoperative MRI, showing a very high rate of repairs that failed to heal. This was quite surprising to the orthopedic community as surgeons realized that their treatment efforts were not as successful and they may have assumed or hoped. After witnessing some patients in his training program who were unhappy after rotator cuff surgery, Dr. Meier was struck by this deficiency and committed to finding a way to improve the treatment results for this common condition.
At the time, arthroscopic shoulder techniques were just being developed, and the use of suture anchors was replacing the older fixation technique of transosseous sutures. Suture anchors were typically placed in a single-file fashion along the edge of the tendon repair. Dr. Meier, who was still in training at the time, noticed that some of these repairs appeared quite tenuous, and he wondered how well they would remain intact during weeks of healing when some seemed barely strong enough to hold together until the end of the case. As he observed his attending surgeons performing rotator cuff repairs, he imagined rearranging the fixation implants differently with two rows of anchors instead of just one and that it might provide more robust fixation. Dr. Meier began to experiment with this double-row fixation concept in the laboratory and present the technique at orthopedic conferences.
After completing his formal training while sitting on a park bench studying journal articles overlooking the Hudson River in Hoboken, New Jersey, Dr. Meier came across a research study, Apreleva et al. Arthroscopy 2001. In this experiment, the investigators used newly developed 3-dimensional digital mapping technology. They showed how conventional rotator cuff repair methods failed to fully restore the normal bony attachment of the rotator cuff tendons. Dr. Meier recalled his idea for rearranging the fixation implants in a geometric pattern versus the traditional linear fashion. He thought it would be important to prove that double-row fixation better restored the native anatomy and provided a more substantial repair, creating a better environment for healing.
This prompted Dr. Meier to go back into the laboratory to test his theory. With his brother Jeffrey Meier, DO, also an orthopedic surgeon, he used cadaveric shoulders from organ donors to test the double-row fixation technique.
They performed rotator cuff repairs on one group of cadaveric shoulders using double-row fixation and in another group using traditional single-row fixation for comparison. They tested the specimens for several biomechanical parameters, including tendon-bone contact area, strength, and micromotion. They found that the anatomic double-row fixation technique was biomechanically superior to single-row methods in every way. Double-row fixation allowed the complete restoration of the tendon-bone attachment site maximizing contact area. It exponentially improved the strength and durability of the repair. And it minimized micromotion between tendon and bone that would occur during the healing phase.
Dr. Meier published these groundbreaking studies with his brother and proceeded to travel the world to present their findings. Dr. Meier presented the results of their work at medical conferences throughout the United States, Europe, Asia, South America, and Africa.
Early on, this new surgical technique was far from widely accepted. Many surgeons criticized the double-row approach, claiming that it would be technically too challenging for general orthopedic surgeons to perform and that using more fixation devices would add too much expense. However, as clinical studies were conducted, first by one of Dr. Meier’s collaborators, Hiroyuki Sugaya, MD, in Japan and then others, it became apparent that anatomic repairs with double-row fixation did indeed result in better healing rates than conventional single-row methods. Since then, while it has not yet become universally adopted, more and more orthopedic surgeons have been making an effort to learn the technique and utilize double-row fixation to help improve their rotator cuff healing results.
To allow more patients to benefit from this technical advance, Dr. Meier has dedicated himself to traveling far and wide to teach other surgeons how to perform this more complicated surgery using a streamlined and organized, stepwise approach that he developed.
While better repair techniques are essential to improving rotator cuff healing, this still does not entirely solve the healing problem in all individuals. Many rotator cuff patients are afflicted with an inherent biologic response that is inadequate to heal the repair no matter how robust the fixation is. Even an excellent repair technique alone does not guarantee success in all patients if their biologic response is inadequate to heal the repair. Dr. Meier realized that in addition to improving fixation technique, the notorious insufficient biologic response was the other crucial factor that would have to be addressed to optimize rotator cuff healing fully. As it happened, in 2014, Dr. Meier started to become interested in orthobiologics and regenerative medicine and the concept of using the body’s own cellular mechanisms to help stimulate healing for various conditions. He wondered if this approach could play a role in rotator cuff tear treatment. Studies have shown that in patients who have chronically torn rotator cuffs, the bone marrow in the greater tuberosity of the humerus to which rotator cuff tendons attach progressively become deficient in marrow cells necessary for healing. It became clear that the resultant loss in biologic activity may need to be addressed for a structural repair to succeed more consistently. After studying the work of Phillipe Hernigou, MD in Paris, Dr. Meier began incorporating patients’ bone marrow aspirate concentrate into their rotator cuff repairs. He developed a technique where bone marrow aspirate concentrate derived from the pelvic bone is hand processed for a finely-tuned end product and infused into the bone of the humerus to regenerate the depleted marrow. Dr. Meier found that by combining this biologic enhancement with the superior mechanical properties of double-row fixation, rotator cuff healing rates could approach nearly 100% compared to the conventional average of only 60-70%! All of this work led Dr. Meier to develop the Meier Double-Row with Bio-Boost Rotator Cuff Repair technique.
In addition to shoulders, Dr. Meier has always had a passion for treating knee conditions. Early on, Dr. Meier became interested in addressing the problem of cartilage injury in the knee. This is a widespread, debilitating condition but has traditionally had minimal treatment outside of knee replacement surgery. Dr. Meier was one of the early adopters of osteochondral graft transfer, which allows the repair of small-to-medium-sized cartilage lesions.
Then, in the early 2000s, Dr. Meier became one of the first surgeons in the United States to begin regenerating cartilage for large cartilage lesions by performing autologous chondrocyte implantation in the knee, a technology initially developed in Europe. Autologous chondrocyte implantation (ACI) and now matrix-induced autologous chondrocyte implantation (MACI) involves using a tiny piece of a patient’s healthy cartilage cells to culture, grown in a laboratory, and reimplant to regenerate and heal cartilage lesions in their knee. Even though cartilage injury frequently occurs along with ligament injuries such as anterior cruciate ligament (ACL) tears, surgeons often ignored these cartilage lesions in the past due to an underappreciation of their impact on functional results. Because of his experience with cartilage regeneration, Dr. Meier began emphasizing the importance of treating these lesions along with ACL reconstruction surgery for best results.
Sometime later, in 2014, as Dr. Meier began exploring orthobiologics and regenerative medicine using bone marrow aspirate concentrate, he found that he could concentrate and transfer a patient’s marrow cells to heal bone marrow lesions associated with knee arthritis. This prompted him to develop the biologic knee rejuvenation or Meier Bio-KneeJuvenation procedure to help patients with arthritis avoid knee replacement surgery.
During his career as an orthopedic surgeon, Dr. Meier found that while surgical treatment is very effective in addressing specific types of musculoskeletal conditions, surgery is not always the best solution for all situations. Conservative therapy can effectively treat many painful musculoskeletal disorders. A non-surgical treatment that has been in widespread use for a long time is corticosteroid injection therapy. But while temporarily masking pain due to inflammation, corticosteroids are associated with a long list of adverse effects. Corticosteroids can lead to the acceleration of degenerative joint disease, tissue degradation, avascular necrosis, increased blood sugar levels, decreased bone density, weight gain, and immunosuppression.
Dr. Meier found that there was a significant void in the area of non-surgical musculoskeletal care. This need for better non-surgical orthopedic treatment prompted Dr. Meier to become interested in regenerative injection therapies. In 2014, he began exploring dextrose injection modalities. He studied traditional prolotherapy techniques with the Hackett-Hemwall Foundation at the University of Wisconsin, Madison. And then perineural injection treatment (PIT) with its originator, John Lyftogt, MD, from New Zealand. Dr. Meier found that both of these approaches had their benefits, but they also had particular limitations. This inspired him to develop a unique, hybrid technique of Dextrose Injection Therapy (DIT), combining the benefits of both.
Delving further into the realm of regenerative injection therapy, Dr. Meier proceeded to explore the use of bone marrow aspirate concentrate (BMAC). He found that the commercial kits sold for preparing these biological products limited the practitioner’s amount of control over the final product. So, after years of research and development in the laboratory, he developed a proprietary method of preparing BMAC by hand to optimize the finished product for better results.
Dr. Meier found that in addition to being highly effective in treating knee and shoulder conditions, regenerative injection therapies have also become quite effective in managing painful spine conditions. And observing that many patients are often dissatisfied after elective spine surgery that also involves significant risks of complications, he knew that an effective nonsurgical treatment for neck and back pain would be particularly beneficial. This prompted him to develop a proprietary BMAC/DIT spine therapy for chronic back pain that has allowed many patients to enjoy relief of pain and increased physical activity while avoiding invasive spine surgery.
Dr. Meier is passionate about helping patients address their musculoskeletal conditions to reduce pain, restore function and maintain physically active lifestyles. He is a bit of a perfectionist and a firm believer that one must never stop learning and growing, and there is never an end to what one can do to continually refine their craft.
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