Sports Medicine Shoulder & Knee Surgeon in Montgomery County, MD

Remplissage adds a posterior soft-tissue fill to arthroscopic Bankart repair for shoulders with an off-track Hill-Sachs lesion, cutting redislocation risk in a randomized trial without a significant loss of rotation.

Dr. Raffo has performed over 2,000 arthroscopic rotator cuff repairs. This page covers who is a candidate, construct choice, and honest retear rates by tear size and age.

Multidirectional shoulder instability is treated with structured rehabilitation first. Dr. Raffo reserves arthroscopic capsular plication for patients who fail a genuine trial of physical therapy.

Partial-thickness rotator cuff tears are treated differently depending on how much of the tendon is torn. Dr. Raffo explains the more-than-50%-thickness rule and when it applies.

Posterior shoulder instability usually presents as deep, loading-related pain rather than a dislocation, which is why it is frequently missed. Arthroscopic posterior labral repair restores stability in most athletes.

A failed rotator cuff repair can often be revised. Dr. Raffo explains why first repairs fail, what changes the second time, and when revision is not the right answer.

REGENETEN is a collagen implant used to augment rotator cuff repair or treat partial tears. It measurably reduces retear on imaging; whether it improves how patients feel is less clear.

Dr. Raffo treats anterior, posterior, and multidirectional shoulder instability, from first-time dislocation to revision surgery, tailoring the operation to direction, bone loss, and the demands of the shoulder.

Dr. Raffo performs high-volume ACL reconstruction using quadriceps tendon or BPTB autograft, adding a lateral tenodesis in select high-risk knees.

Bone-patellar tendon-bone autograft is Dr. Raffo's preferred choice for high-level contact athletes and revision ACL reconstruction.

Quadriceps tendon autograft is Dr. Raffo's preferred default graft for primary ACL reconstruction in most active patients under 30.

Agili-C is a single-stage, off-the-shelf cartilage scaffold and the only FDA-approved cartilage implant labeled for use in knees with mild-to-moderate arthritis, though long-term data beyond 2 years remains limited.

The right cartilage procedure depends on lesion size, whether bone is involved, containment, alignment, age, and whether arthritis is already present — not on which implant is newest.

Dr. Raffo adds a lateral extra-articular tenodesis to ACL reconstruction in high-risk pivoting knees because it substantially cuts graft rupture and clinical failure, with an honest look at the unresolved OA question.

MACI is a two-stage cartilage repair that uses a patient's own cultured chondrocytes on a collagen membrane, best suited to larger, contained cartilage defects without significant bone loss.

Dr. Raffo prioritizes meniscus repair over meniscectomy whenever the tissue and tear pattern allow it, including ramp lesions found at ACL surgery.

Osteochondral allograft transplantation replaces cartilage and the bone beneath it as a single donor unit, used for large lesions, bone loss, and osteochondritis dissecans that cartilage-only techniques can't address.

Revision ACL reconstruction addresses a failed prior graft with tunnel management, graft choice, and near-routine use of a lateral tenodesis.

Partial knee replacement preserves healthy bone and ligaments and comes with a faster recovery, but the honest registry data shows a real revision-rate tradeoff. Dr. Raffo explains how patient selection and surgeon volume change that picture.

Robotic assistance improves alignment accuracy in total knee replacement, but the honest evidence shows no meaningful difference in patient-reported outcomes or revision rates. Dr. Raffo explains why he still uses it.