Andreas H. Gomoll, MD

Ligament Surgery

Ligament tears are a very common sports injury. Some, such as the MCL in the knee, can heal by themselves, while others, most famously the ACL, frequently require ligament reconstruction or repair. Here is a link to Dr. Gomoll explaining ACL reconstruction graft choices.

Different techniques for ACL reconstruction exist, including using portions of your own hamstring, quadriceps or patellar tendon, or donor graft. Which one to have depends on many factors that you will discuss with Dr. Gomoll during your office visit. Overall, a study pooling data from multiple ACL studies found no significant differences in outcomes between hamstring and patellar tendon, but higher rate of complications with the latter. Click here for further information.

Another study reviewing the outcomes of patellar tendon versus hamstring ACL reconstruction in 47,000 patients demonstrated a failure rate of 2.80% versus 2.84% and no differences in knee laxity. Click here for further information.

More recently, the FDA has approved the BEAR implant for repair (rather than reconstruction) of ACL tears. This technique is not applicable to all ACL tears, but can be part of the broader discussion about treatment options for the injury. It involves placing a collagen sponge next to the injured ACL to encourage healing. This surgery does not require harvesting of tendon tissue, or the use of donor tendon, to reconstruct the ACL. Dr. Gomoll has been using this technique since early 2022, specifically for so called proximal ACL tears with good residual tissue. Generally, patients with recent tears are the best candidates for the procedure. Click here for further information.

Cartilage Repair

Cartilage is the smooth articular surface covering wherever two bones meet to form a joint. It can be damaged through acute trauma, developmental abnormalities or chronic degeneration. Localized cartilage damage is referred to as focal defect, while more widespread, diffuse disease is termed osteoarthritis.

There are multiple options to address cartilage damage, ranging from various cartilage repair procedures for focal defects, all the way to partial and total knee replacement for widespread bone-one-bone osteoarthritis.

Discover more about these procedures here 

Osteotomy

When legs are straight, the forces across the knee joint are evenly distributed. Occasionally, however, the alignment is off, either congenitally, due to trauma or degeneration. This so-called malalignment can increase the rate of further degeneration.

It can be addressed through osteotomy procedures, where the malaligned bone is cut and realigned, then held in place with a plate until it heals. The plate can later be removed in a simple outpatient procedure.

Arthritis Surgery

Sometimes cartilage damage is too far progressed to treat with cartilage repair procedures, for example, in bone-on-bone arthritis. 

In these cases of more advanced arthritis, knee replacement surgery offers pain relief, either through partial or total replacement of the knee joint.

Discover more information on these procedures here.

Rotator Cuff Repair

The rotator cuff is the most important system of muscles and tendons for shoulder function. Other muscles include the deltoid, biceps and pec muscles.

The rotator cuff can be injured acutely through trauma, for example slipping on black ice and coming down hard on the arm and shoulder, or through years of repetitive stress. Tears can be repaired through arthroscopic surgery without the need for large incisions.

Shoulder Instability Repair

Sports injuries can lead to shoulder dislocations, where the shoulder joint "pops out of place". Generally, shoulder dislocations are treated acutely on the field or in the ER by reducing the joint back to its normal position. Unfortunately, a significant number of patients go on to experience problems where the shoulder does not feel stable, or continues to dislocate.

The shoulder can be made stable through arthroscopic surgery to tighten up the capsule and repair the torn labrum.