The orthopedic surgeon standing in an operating room in the late 1990s, trained by world-renowned orthopedic sports medicine surgeon Dr. James Andrews in Birmingham, Alabama, and the physician who today leads a pioneering regenerative medicine orthopedic practice in upstate New York, are separated by more than geography. Between those two points lies a career defined by a willingness to question received wisdom, accept the consequences, and build something better from what did not work.
Dr. Marc Pietropaoli is the founder of Victory In Motion, Home of Knee Repair, NOT Knee Replacement® and a fellowship-trained orthopedic surgeon with more than 30 years of clinical experience who has systematically moved away from surgery as a default and toward regenerative medicine approaches that address the underlying biology of joint degeneration.
The path was not a straight one. After completing his sports medicine fellowship under Dr. Andrews, Pietropaoli joined a traditional orthopedic group before recognizing that its culture did not match his standards for patient care. In 2001, he left to start his own independent practice, a decision that placed him outside the growing consolidation of large hospital systems and corporate medical groups. The structural challenges were real. So was the freedom.
That freedom allowed him to explore new approaches earlier than many of his peers. Pietropaoli began working with platelet-rich plasma (PRP) in the late 1990s and early 2000s, well before PRP became widely recognized in sports medicine. He introduced bone marrow aspirate cells procedures, which has stem cells and other cells that help the stem cells, in 2017. He was also among the early adopters of MLS healing laser therapy in orthopedic practice, a technology that later evolved into what is now known in his practice as the V-Motion Laser system. Over time, he began helping other physicians learn how to integrate therapeutic laser into orthopedic care, building what Pietropaoli jokingly refers to as his “laser coaching tree,” a sports reference to the network of colleagues who learned and expanded on similar techniques after training with him.
The same instinct led him to the BEAR ACL repair procedure, a technique designed to repair rather than reconstruct the anterior cruciate ligament using a biologic scaffold. When the procedure received FDA approval, Pietropaoli became the first surgeon to perform an FDA-approved BEAR ACL repair procedure outside of clinical trials. The milestone earned formal recognition from Cayuga and Onondaga Counties in New York and acknowledgment on the floor of the United States Congress. October is now officially designated Cayuga County ACL Awareness Month in part because of that work.
The philosophy that emerged from these experiences, Knee Repair, NOT Knee Replacement®, first articulated in 2014 and trademarked in 2021, reflects a structural argument about how orthopedic medicine has historically been organized: around surgical volume, insurance reimbursement models, and the assumption that severe arthritis is primarily a surgical problem. Pietropaoli has spent years demonstrating that this assumption is not always warranted.
His Amazon #1 bestselling book Repair NOT Replace™ is the most public expression of that argument. The book reached #1 in Orthopedics and Medical Procedures on Amazon and has become a widely shared resource for patients researching alternatives to knee replacement surgery. It connects clinical philosophy with patient empowerment and links book sales to support for the Arthritis Foundation through the $1 vs $1 Million Challenge.
The book also serves as a bridge to the initiative Pietropaoli calls Knee Replacement Free by ’43, a long-term mission to eliminate the need for knee replacements by the year 2043 through earlier diagnosis, improved biologic tools, and comprehensive regenerative medicine approaches to musculoskeletal health.
The practice that emerged from more than three decades of clinical work, professional risk, and deliberate reinvention is far removed from the operating room where this story began. In Pietropaoli’s view, that transformation is exactly the point. #KneeReplacementFreeBy43
