Grant H. Garcia, MD

10/14/2026

ELBOW ARTHROSCOPY: SETUP MATTERS. **💪🔬

My newest surgical technique video walks through my TriMano arm-holder setup for elbow arthroscopy-from positioning all the way through the full procedure.

In this case, we’re treating a young athlete with an elbow osteochondritis dissecans (OCD) lesion.

The TriMano setup provides controlled positioning of the arm throughout the case while maintaining the access and flexibility needed for arthroscopic treatment.

🔹 Step-by-step TriMano positioning and setup

🔹 Portal placement and arthroscopic evaluation

🔹 Identification of the OCD lesion

🔹 Arthroscopic removal of the unstable OCD fragment

🔹 Assessment of the remaining joint and cartilage

For young athletes, the goal isn’t simply to remove the symptomatic lesion. It’s to treat the pathology while minimizing surgical morbidity and creating the best opportunity for a safe return to sport.

And the best part of this case?

This athlete was able to get back quickly to the sport they love. **🙌

🎥 Check out the full technique video to see the setup and procedure from start to finish.

https://youtu.be/04DqV1RCnVQ

Great surgery starts before the first incision.

https://www.grantgarciamd.com/elbow-arthroscopy-shoulder-knee-sports-surgeon-seattle-bellevue-everett-kirkland-wa.html

https://www.grantgarciamd.com/elbow-osteochondritis-dissecans-surgery.html

ELBOW ARTHROSCOPY: SETUP MATTERS. 💪🔬My newest surgical technique v...

10/13/2026

🏈 REMPLISSAGE IN A THROWER - INNOVATION STARTS HERE.

One of the toughest challenges in shoulder instability surgery? Elite throwing athletes.

When a high-level quarterback presented with shoulder instability and a Hill-Sachs lesion, we faced a difficult decision.
🔹 Standard Bankart repair: Approximately 7–10% recurrence, potentially higher in contact athletes.
🔹 Bankart + Remplissage: Recurrence rates as low as 3% in selected studies, but limited data in elite throwers and concerns about throwing mechanics.

Our goal wasn’t just stability. It was getting him back to throwing at the highest level.

After extensive discussions with my patient and his family, we made the decision TOGETHER to pursue remplissage-with a modification.

Drawing on my experience with shoulder instability surgery and Arthrex technology, I modified the infraspinatus fixation point to create a steeper trajectory, aiming to preserve throwing mechanics without sacrificing stability.

I call it “Remplissage Minus” - a modified technique for throwers.

The comeback?
🔥 Back as the STARTING QUARTERBACK.
🔥 One of Washington State’s top-ranked QBs.
🔥 Leading his team to a 5–1 record.

Last Friday, I drove 30 minutes through the Washington rain to watch him play.

And it did NOT disappoint. 🏈

Seeing him back on the field after months of hard work was incredible.

Innovation isn’t always about reinventing surgery. Sometimes it’s about modifying what works to meet the demands of an exceptional athlete.

Congratulations on an amazing comeback! Thank you to my patient and his family for trusting the process and allowing us to push the boundaries of return to sport.

More to come on remplissage, innovation, and this story!

Posted with patient and family permission. Individual results vary; further research is needed in elite throwers.

10/12/2026

Why “Injury Prevention” May Be the Wrong Phrase

Is “injury prevention” the right way to talk about injuries in elite athletes? ⚠️

In our conversation with Dr. Travis Maak, we discuss why “injury mitigation” may be a more accurate framework.

When an athlete straps on skis or steps onto the court, pushing physical limits is fundamental to the job. Calling every injury preventable can imply that getting hurt represents a failure by the athlete or medical team.

The better question: how do we understand risk, manage workload, and reduce the likelihood or severity of injury without pretending risk can be eliminated?

🎬 Featured clip: *https://www.youtube.com/shorts/RWRCBOEP_Qg

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

10/07/2026

⚠️ PEPTIDES: IT’S NOT JUST “DO THEY WORK?”

The peptide market is exploding. 🧬📈
But marketing has moved much faster than the evidence.

Before using a peptide, there are bigger questions:

🧪 What’s actually in the product?

💉 Is the dose and purity reliable?

⚠️ What safety data actually exists?

🏆 And for athletes-*is it banned?*

Many peptides promoted online for healing or performance are not FDA-approved for those uses, and FDA has raised safety concerns about certain substances used in compounding.

For competitive athletes, the stakes are even higher. 🚨

WADA prohibits multiple peptide hormones, growth factors and related substances-including several commonly discussed in the performance and recovery world.

🎯 Bottom line: “available online” does NOT mean proven, safe, approved-or permitted in competition.

Patients and athletes deserve to know the science AND the rules.

🎥 Video 25: Peptide Therapy - Regulation, Safety & Athlete Considerations

https://youtube.com/shorts/u3ujibjA-kE

Full Surgical Nutrition Series: https://www.grantgarciamd.com/nutrition-shoulder-knee-sports-surgeon-seattle-bellevue-everett-kirkland-wa.html

⚠️ PEPTIDES: IT’S NOT JUST “DO THEY WORK?”The peptide market is ex...

10/05/2026

MENISCAL ROOT REPAIR IS EVOLVING. 🦵🔬

My newest surgical technique video demonstrates a medial meniscus root repair using SutureLoc-combined with a centralization stitch using an Arthrex FiberStitch.

Why add the centralization?

A root tear doesn’t just detach the meniscus-it can allow the meniscus to extrude outside the joint, compromising its ability to distribute load and protect the cartilage.

🔹 SutureLoc - Anatomic fixation of the medial meniscus root

🔹 FiberStitch centralization - Helps address the extruded meniscus and restore its position over the tibial plateau

🔹 The goal - Repair the root AND address the extrusion rather than treating the root tear alone

The emerging data are compelling. Biomechanical studies demonstrate improved meniscal mechanics with centralization, and recent clinical studies suggest it can reduce or limit progression of meniscal extrusion. The long-term clinical advantage over isolated root repair is still being defined.

This has changed my practice.

For isolated medial meniscus root tears with significant extrusion, I now add a centralization stitch in approximately 50% of my cases.

It’s another example of how meniscus surgery is moving beyond simply “fixing the tear” toward restoring the anatomy and biomechanics of the entire meniscus.

🎥 Check out the new technique video to see the SutureLoc + FiberStitch centralization construct in action.

https://youtu.be/rneHE9tzuLg

https://www.grantgarciamd.com/meniscal-shoulder-knee-sports-surgeon-seattle-bellevue-everett-kirkland-wa.html

MENISCAL ROOT REPAIR IS EVOLVING. 🦵🔬My newest surgical technique v...

10/01/2026

How the NBA Used Data to Address Achilles Injury Spikes

Why did the NBA suddenly see a massive spike in Achilles tears? 🏀

On Sports Doc Talk, Dr. Travis Maak takes us behind the scenes of how the league brought experts together to examine the problem.

The discussion explores analytics, video motion capture, workload, and the physical thresholds elite athletes face across an NBA schedule-and why load management is more than a buzzword.

🎬 Featured clip: https://www.youtube.com/shorts/yTWOvKziVcY

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

09/30/2026

🧬 PEPTIDES IN ORTHOPEDICS: EXCITING SCIENCE-BUT ARE WE THERE YET?

Peptide therapy is one of the fastest-growing trends in regenerative orthopedics. 📈

The theory is compelling:

🦵 Tendon repair

💪 Muscle regeneration

🔥 Inflammation modulation

🧬 Biologic signaling for healing

But here’s the important part:

🔬 Most evidence remains preclinical

❌ No injectable peptides are currently FDA-approved for orthopedic use

❓ Optimal dose, timing & frequency remain undefined

📊 We still need high-quality randomized clinical trials

My approach: cautious optimism.

Follow the science. Understand the potential. But don’t confuse an exciting biologic concept with a proven clinical treatment. 🎯

🎥 Video 24: Peptides - What Does the Evidence Actually Say?

https://youtu.be/pqyr0QRwjOk

📚 Reference: Mayfield CK, Bolia IK, Feingold CL, et al. Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians. American Journal of Sports Medicine. 2026;54(1):223-229.

Full Surgical Nutrition Series: https://www.grantgarciamd.com/nutrition-shoulder-knee-sports-surgeon-seattle-bellevue-everett-kirkland-wa.html

🧬 PEPTIDES IN ORTHOPEDICS: EXCITING SCIENCE—BUT ARE WE THERE YET?P...

09/30/2026

Is physical therapy or surgery right for your joint injury? Discover how diagnosis, activity goals, and rehabilitation work together to get you back to the activities you love.
Read the full guide: https://www.grantgarciamd.com/blog/orthopedic-surgery-vs-physical-therapy-which-is-right-for-patients-in-seattle-bellevue-everett-kirkland-wa-53931.html

When pain or an injury starts interfering with exercise, work, or everyday activities, deciding between physical therapy and orthopedic surgery can be challenging.

09/29/2026

ACL injuries may get an early-warning system through AI and wearable sensors

Dr Grant Garcia, a shoulder surgeon in Seattle, Bellevue, Everett and Kirkland, WA offers treatment for rotator cuff pain and shoulder pain. Click here to read healthcare news.

09/28/2026

Updated to make the dovetail technique a key part of the hook:

2 YEARS AFTER A DOVETAIL LATERAL MENISCUS TRANSPLANT… **👀🦵

It’s not often we get the opportunity to see a meniscus transplant again 2 years later.

This patient underwent a dovetail lateral meniscus allograft transplant.
After developing some clicking, we went back in with an arthroscope and found only mild scar tissue.

The best part?

🔹 The dovetail meniscus transplant remained in place
🔹 Only mild scar tissue was encountered
🔹 And visually, it was remarkably difficult to tell this was a transplanted meniscus.

🎥 In this new surgical video, you can see the 2-year second-look arthroscopy and the appearance of the transplant firsthand.

https://youtu.be/FMu17WU0EMs

The dovetail technique is designed to provide bone-to-bone fixation of the
meniscal roots while allowing anatomic positioning of the transplanted meniscus.

Meniscus transplantation isn’t simply about replacing missing tissue. The
goal is to restore meniscal function and joint mechanics and help preserve
the knee in appropriately selected patients who have lost their native meniscus.

Meniscus preservation when possible. Meniscus restoration when necessary.
🦵

Individual outcomes vary. Meniscus transplantation is reserved for appropriately selected patients.

https://www.grantgarciamd.com/media-and-news-shoulder-knee-sports-surgeon-seattle-bellevue-everett-kirkland-wa.html