For Joseph Papa, the tear in his knee took only a split second – both times.

The first time the Westmont High School senior tore his anterior cruciate ligament (ACL), his basketball team was on a winning streak in the 2022 Blossom Valley Athletics League playoffs. He was backpedaling to block an opponent when another player hit his shoulder and he heard his right knee snap.

He tried to power through the rest of the game, but couldn’t control his knee and had to leave the court. Worse than the injury, for the then 18​​-year-old, was the knowledge that he had just received several college basketball scholarships and was terrified of losing them.

I was at an all-time low.”

Joseph Papa, student athlete

The ACL is a key ligament that stabilizes the knee joint. It connects the thighbone (femur) to the shinbone (tibia) and is usually torn during sports that involve sudden stops and changes in direction, like soccer, football, volleyball and, in Joseph’s case, basketball.

A year later, as a college freshman, Joseph was a part of the California Lutheran University basketball and track-and-field teams, the Kingsmen, in Southern California. He’d been cleared for post-surgery competitive sports by his South Bay surgeon, had completed six months of physical therapy and wore a knee brace as recommended whenever active. He was playing basketball again, when he landed awkwardly after a shot and heard the familiar pop. This time the pain was excruciating. He’d re-torn his partially healed ACL.

Come back from an all-time low

Determined to try a new approach for his son, Tom Papa contacted Nirav Pandya, MD, an orthopedic surgeon at UCSF Benioff Children’s Hospital Oakland. Tom Papa had listened to Pandya’s medical commentaries on 95.7’s The Game sports radio station and followed Pandya’s tips on preventing athletic injuries. He felt strongly that the 90-minute drive to the East Bay from their home in Campbell, California, would be worth the trip.

“I was at an all-time low,” said Joseph Papa, who traveled to the UCSF Benioff Children’s Hospitals – Walnut Creek Outpatient Center for his care. “But within minutes of our first visit, Dr. Pandya put the hope of playing basketball and running back into my soul.”

Nirav Pandya, MD, sits on a bench in an exercise and physical therapy room.
Nirav Pandya, MD. Photo by Steve Babuljak

Pandya, an orthopedic surgeon at UCSF Benioff Children’s Hospitals for 13 years, has repaired hundreds of ACL tears for children and young adults up to 22 years old. Sometimes performing ACL surgeries on up to four patients a day, Pandya – himself an athlete – is passionate about getting children and young adults rehabilitated enough following surgery to continue playing their sport at their highest and safest levels.

“Joey’s recent ACL tear was severe, but not unusual for a basketball injury,” Pandya said. “He was clearly eager to continue playing basketball and sprinting competitively through college, so he had to understand the importance of letting his body fully heal following surgery and completing rigorous physical therapy to build back his muscle strength and endurance.

“A second surgery on the same joint is often more complex due to scar tissue and operating on a knee that has already had major reconstructive surgery,” Pandya continued, "but we see and successfully manage these types of complex cases all the time.”

For the revision ACL surgery, Pandya used a procedure called a lateral extra-articular tenodesis, which helps to provide additional stability to the knee that a young athlete, in particular, would need.

Return to sports

A young athlete named Joey Papa sits on a physical therapy bench at a gym while a medical professional treats his knee with a massage.
With the proper care, “there is no reason he cannot eventually return to his sports,” said Pandya of Joseph, pictured above receiving care on his knee. Photo courtesy of Joseph Papa

Since his surgery last year, Joseph has had to watch the Kingsmen from the sidelines, but practices with the team between his classes and physical therapy sessions. His goal is to build strength and flexibility with his personal trainer for six hours daily during the summer to prepare for the fall 2024 basketball season. His rehabilitation this time will be twice as long, but Joseph is undeterred.

“I’m not ready to give up,” Joseph said, “and Dr. Pandya has told me I don’t have to as long as I commit to my rehab and do what it takes. I’m all in.”

Joseph’s second knee surgery went smoothly and as expected, Pandya said. “So, with continued physical therapy, ACL injury prevention exercises, having confidence in his knee and not rushing back onto the court too quickly after getting surgery, there is no reason he cannot eventually return to his sports.”

Joseph continues to have follow-up appointments with Pandya and sometimes even consults with him via text, giving him confidence that Pandya is available if needed.

“Dr. Pandya is a Godsend,” Joseph said. “He treated me and my parents with the utmost respect with a laser focus on finding a way for me to get back to playing the sports I love.”