Armando Vidal, MD

05/31/2026

What does shoulder instability look like in a young athlete?

It’s not always a full dislocation. More often, kids and teens describe:
· A shoulder that feels unreliable
· Clicking, popping, or shifting with activity
· Pain when serving, throwing, or reaching overhead
· Subtle loss of strength or control in sport

The key is that symptoms are often intermittent, not constant.

Persistent instability can affect both performance and long-term joint health.

What is shoulder instability in children? The upper arm bone (humerus) sits in a shallow socket in the main part of the shoulder joint called the glenoid. The shoulder capsule and ligaments hold the bones of the shoulder securely in place. An injury to the ligaments or shoulder capsule can cause the...

05/29/2026

What is the goal of patellofemoral chondral injury repair?

The goal is not just to “reduce pain,” but to restore a smoother cartilage surface and improve how forces are distributed across the kneecap joint.

Successful treatment focuses on biology, alignment, and mechanics, not just symptom suppression.

The best outcomes come from addressing the underlying defect, not just the inflammation around it.

What is Patellofemoral Chondral Pain? Patellofemoral pain refers to the area where the patella (kneecap) meets the femur (long bone in the thigh). The term chondral refers to a special type of cartilage in the knee known as the articular cartilage. You’ve seen this substance on the ends of chicken...

05/28/2026

Not all ligaments need to be rebuilt. Not all tears can heal.

Multil-igament knee reconstruction is a selective, anatomy-driven approach:
• Preserve what can heal
• Reconstruct what cannot
• Restore native biomechanics with precise graft placement

Technique is important, but decision-making is everything. Learn more
https://armandovidalmd.com/multi-ligament-reconstruction-orthopedic-surgeon-vail-aspen-denver-colorado/

What is a Multi-Ligament Injury? Five major structures work together to stabilize the knee joint (four major ligaments and a complex called the posterolateral corner). These ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament....

05/27/2026

Are platelet rich plasma, bone marrow aspirate concentrate, and stem cells truly regenerative treatments?

They’re best understood as biologic modulators, not tissue replacements.

PRP signals healing through growth factors, while BMAC adds a cellular component that may enhance the local environment. Their goal is to reduce inflammation and support repair—not directly rebuild tissue.

Results vary because indication matters as much as the injection itself. Acute injury, degeneration, and patient selection all respond differently.

What is a Biologic Treatment? In the past, orthopedic advances have centered on surgical techniques, new joint materials and new methods of operating, such as arthroscopic surgery. Today, biologic treatments have become the cutting edge of orthopedic treatment. Due to their regenerative properties,....

05/26/2026

Why do some children with knee cartilage injuries recover quickly while others struggle for months?

Not all pediatric cartilage injuries are the same and that distinction drives outcomes. Most cases fall into two groups:
1. Isolated cartilage injury – surface damage with intact underlying bone
2. Osteochondral injury / osteochondritis dissecans – cartilage plus bone involvement

This difference matters. Pediatric cartilage has strong healing potential, but only when the subchondral bone environment is stable and biologically active. Stability, growth status, and lesion type determine whether non-operative care is appropriate or if surgical restoration is needed.

Symptoms can be misleading. Mild pain or intermittent swelling may still reflect a structurally significant lesion.

In pediatric cartilage injury, success depends less on symptoms and more on lesion biology, stability, and timing of intervention.

What is the Articular Cartilage? Articular cartilage is a complex, living tissue that lines the bony surface at the end of a joint. Its job is to make the bones glide smoothly against each other while moving or bearing weight. In children, articular cartilage injuries are usually caused from trauma....

05/25/2026

In medicine, we’re trained to preserve life and restore function. Memorial Day humbles us with the reminder that countless service members gave both in defense of others.

05/24/2026

A total meniscectomy is sometimes necessary, but it’s not the first choice.

It involves removing the full meniscus tear when it cannot be saved.

Because the meniscus acts as a shock absorber, removing it increases stress on the knee joint, which can speed up arthritis over time.

That’s why recovery, strengthening, and long-term joint protection become especially important afterward.

What is the anatomy of a meniscus? Each knee has two menisci which are wedge-shaped fibrocartilage discs that act as shock absorbers. The peripheral third of each meniscus has a blood supply which facilitates healing and influences our decision on whether to repair or resect the torn portion. The in...

05/23/2026

Knee pain isn’t always just “wear and tear, ”sometimes it’s a geometry problem.

Knee malalignment refers to the deviation of the mechanical axis from neutral alignment.

In an ideal limb, a straight line from hip → knee → ankle passes through the center of the knee.

When it shifts:
· Medial shift → varus (“bow-legged”)
· Lateral shift → valgus (“knock-kneed”)

Understanding coronal plane alignment is critical for preventing asymmetric joint loading and guiding surgical decision-making.

What is Malalignment of the knee? Malalignment is a complex topic and can occur in and of the three (X,Y Z) planes. For this section, we will focus on the most common malalignment – the coronal or frontal plane. In the ideal setting, if we drew a line from the center of your hip to the center

05/22/2026

19-year-old soccer player. Non-contact knee injury. Immediate swelling.

MRI confirmed an ACL tear, but the bigger question was what would give this athlete the best chance at returning to sport without another injury.

For high-demand athletes, graft choice matters. Stability matters. Meniscus preservation matters even more.

ACL reconstruction is never just about replacing a ligament. It’s about restoring confidence, movement, and long-term joint health.

What is an ACL? Those 3 dreaded letters….ACL. Every athlete fears hearing them but regrettably ACL injury is part of sporting activities. Thankfully techniques to repair and reconstruct the ACL have advanced considerably in the past few years and as such, our ability to return an athlete to sport ...

05/21/2026