Repair vs. Reconstruction
Most repairs aren’t ruled out on clinical grounds. They’re ruled out on scheduling grounds. Those are not the same thing.
Reconstruction is faster. It is more predictably covered by insurance. It is what most surgical training is optimized for. And in a system built around three-minute visits and packed OR schedules, it became the path of least resistance for conditions that, in many cases, could have been repaired.
Repair requires more time in the room, more diagnostic patience, and, in many cases, a technique the previous surgeon was not trained to perform. Those are not clinical reasons to default to reconstruction. They are logistical ones.
With Dr. Mora, every case begins with a single question: Can this be repaired? Not every case is a repair candidate. The tissue has to support it. The timing has to be right. The metabolic environment has to be prepared. But every case deserves the question — and the time it takes to answer it honestly.
If reconstruction is the correct answer, that is what is recommended. If repair is viable, a plan is built around it. The difference here is that both options receive a fair hearing before the surgery is scheduled.
How this applies across procedures.
Repair-first is not a blanket policy — it is a clinical discipline applied differently depending on the injury, the tissue, the patient's timeline, and the life they are trying to get back to. What it looks like for an ACL is not what it looks like for a chronic pec tear. What it requires for a meniscus is not what it requires for an Achilles. What follows is a procedure-by-procedure breakdown of how the repair-first standard is applied across the specialties at this practice — and what that means for the patient sitting across the desk with a diagnosis that may not yet be complete.
Reconstruction is the default in modern sports medicine. Repair is the question that gets asked first.
ACL repair is appropriate for specific tear patterns, specific patient profiles, and specific activity demands. It is not the answer in every case — but it is a question that a growing body of evidence supports asking, and one that a three-minute visit does not have time to answer properly. The workup includes tear pattern, tissue integrity, time since injury, and the athletic demands the patient intends to return to. Reconstruction is performed when it is the right answer. Repair is performed when the tissue and the evidence support it.
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The consultation is not a sales process. It is a workup. If reconstruction is right, that will be the recommendation. If repair is viable, a plan gets built. Either way, the patient leaves with a clinical answer, not a calendar date.