Procedures
Shoulder and knee procedures Dr. Raffo performs, with his own reasoning behind each technique choice, the tradeoffs involved, and the evidence the recommendations rest on.
Shoulder Procedures
Arthroscopic Bankart Repair with Remplissage
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.
Learn more shoulderArthroscopic Rotator Cuff Repair
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.
Learn more shoulderMultidirectional Instability (MDI) Treatment
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.
Learn more shoulderPartial-Thickness Rotator Cuff Tear Treatment
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.
Learn more shoulderPosterior Shoulder Instability Repair
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.
Learn more shoulderRevision Rotator Cuff Repair
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.
Learn more shoulderRotator Cuff Repair with REGENETEN Bioinductive Implant
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.
Learn more shoulderShoulder Instability Surgery
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.
Learn moreKnee Procedures
ACL Reconstruction
Dr. Raffo performs high-volume ACL reconstruction using quadriceps tendon or BPTB autograft, adding a lateral tenodesis in select high-risk knees.
Learn more kneeACL Reconstruction with BPTB (Patellar Tendon) Autograft
Bone-patellar tendon-bone autograft is Dr. Raffo's preferred choice for high-level contact athletes and revision ACL reconstruction.
Learn more kneeACL Reconstruction with Quadriceps Tendon Autograft
Quadriceps tendon autograft is Dr. Raffo's preferred default graft for primary ACL reconstruction in most active patients under 30.
Learn more kneeCartiHeal Agili-C Implant
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.
Learn more kneeKnee Cartilage Restoration
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.
Learn more kneeLateral Extra-Articular Tenodesis (LET) with ACL Reconstruction
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.
Learn more kneeMACI (Matrix-Induced Autologous Chondrocyte Implantation)
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.
Learn more kneeMeniscus Repair
Dr. Raffo prioritizes meniscus repair over meniscectomy whenever the tissue and tear pattern allow it, including ramp lesions found at ACL surgery.
Learn more kneeOsteochondral Allograft Transplantation
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.
Learn more kneeRevision ACL Reconstruction
Revision ACL reconstruction addresses a failed prior graft with tunnel management, graft choice, and near-routine use of a lateral tenodesis.
Learn more kneeRobotic-Assisted Partial (Unicompartmental) Knee Replacement
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.
Learn more kneeRobotic-Assisted Total Knee Replacement
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.
Learn moreOther Procedures
Biologic Augmentation During Surgery
How Dr. Raffo decides whether to add Regeneten, PRP, marrow venting, or BMAC at the time of rotator cuff or meniscal repair, and why he doesn't add one by default just because it's available.
Learn more otherBiologics in Orthopedic Practice
A surgeon's account of which biologic treatments hold up in trials, which he offers, which he declines to offer, and why the honest answer is narrower than the marketing around regenerative medicine.
Learn more otherPlatelet-Rich Plasma (PRP)
A surgeon's account of PRP: the conditions where trial evidence is genuinely strong, the negative trials that get left out of most marketing, and where he draws the line on offering it.
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