Advertise on podcast: The Joint Replacement Podcast

How can you tell whether a hip or knee replacement surgeon is actually good? Dr. Matthew Sloan breaks down the five things patients should look for before choosing a joint replacement surgeon, including surgical volume, board certification, fellowship training, complication rates, revision rates, and the number almost nobody tells patients to ask about: patient-reported outcomes. Patient-reported outcome measures track pain, function, and quality of life before and after surgery. They can reveal something an X-ray cannot: whether patients actually feel and function better after their joint replacement. Dr. Sloan also explains why raw surgeon statistics can be misleading, how risk adjustment accounts for surgeons treating more complex patients, and why public reporting should avoid incentivizing surgeons to “cherry-pick” only healthier, lower-risk patients. The episode also explores what a future national joint replacement scorecard could include: surgeon volume, training, complications, revisions, patient-reported improvement, and risk-adjusted comparisons with national benchmarks. Until that kind of patient-facing system exists, patients may need to ask surgeons and health systems directly for their outcomes. You can view Dr. Sloan’s own patient-reported outcomes at MatthewSloanMD.com. The question to remember before surgery: “Do you track patient-reported outcomes, and can I see them?”

Dr. Will Kang took an unusual path to orthopedic surgery. Before becoming a physician, he was a classically trained violinist who earned a master’s degree in violin performance from the Cleveland Institute of Music and worked professionally as a musician. After years of intense practice and a repetitive-stress shoulder injury, he changed direction and ultimately became an orthopedic surgeon. In this episode, Dr. Matthew Sloan talks with Dr. Kang about the similarities between elite musicians and athletes, repetitive-stress injuries in musicians, and what his experience as a patient taught him about treating musculoskeletal pain. They then tackle some of the most common questions patients have about orthopedic care: When does an injury need evaluation? When do you actually need an MRI? Does every meniscus, labral, or rotator cuff “tear” need to be fixed? Which orthopedic operations may be performed too often? And when does surgery actually offer an advantage over nonsurgical treatment? They also discuss cortisone, PRP, gel injections, regenerative medicine, exercise and joint health, and why significant arthritis on an X-ray doesn't necessarily mean you need a joint replacement. The episode ends with three important questions every patient should ask an orthopedic surgeon before agreeing to surgery.

How do you know when it’s really time for a hip or knee replacement? Dr. Matthew Sloan is joined by Dr. Randall Schultz, a board-certified orthopedic surgeon at Texas Orthopedics and creator of The Surgeon Unmasked. After more than three decades in orthopedic surgery and thousands of joint replacements, Dr. Schultz brings an especially unusual perspective to the conversation: he has also undergone a knee replacement himself. Dr. Schultz shares what becoming a patient taught him about recovery, pain, expectations, and how difficult it can be to decide when surgery is finally necessary. He describes realizing that his own “world was shrinking” as arthritis gradually forced him to give up activities he valued. They discuss: • How to know when hip or knee arthritis is severe enough for surgery• Whether you really need to be “bone on bone”• Whether patients can wait too long for joint replacement• Exercise, weight loss, cortisone, gel injections, PRP, and other nonsurgical options• Partial versus total knee replacement• How to choose a hip or knee replacement surgeon• Whether surgeon volume matters• Robotics versus computer navigation versus manual knee replacement• Whether implant brands actually matter• Anterior versus posterior hip replacement• Subvastus and “minimally invasive” knee replacement approaches• What knee replacement recovery actually feels like• The role of the “quiet knee” approach after surgery• Opioid-free joint replacement and realistic pain expectations• What patients should understand before choosing surgery Dr. Schultz also challenges some of the marketing surrounding modern joint replacement, arguing that technology and branded surgical approaches should not distract from the fundamentals: choosing the right patient, performing the operation well, and setting realistic expectations. For patients considering hip or knee replacement, this episode offers the perspective of someone who has spent his career performing these operations — and has experienced knee replacement from the other side of the operating table. Find Dr. Randall Schultz on YouTube at The Surgeon Unmasked and at TheSurgeonUnmasked.com. Subscribe to The Joint Replacement Podcast on YouTube, Spotify, Apple Podcasts, or wherever you get your podcasts.

What happens to a joint decades before someone needs a replacement—and can we change that trajectory? Duke orthopedic sports medicine surgeon Dr. Jocelyn Wittstein joins Dr. Matthew Sloan to discuss ACL injuries, post-traumatic arthritis, menopause, osteoporosis, cartilage health, and strategies for maintaining healthy bones and joints throughout life. They discuss why ACL reconstruction does not eliminate the risk of arthritis, the importance of the meniscus, whether running causes arthritis, how menopause affects cartilage and joint inflammation, when women should consider bone-density testing, and how resistance training, nutrition, and activity modification may help preserve musculoskeletal health. They also explore treatment options for mild to moderate arthritis, including anti-inflammatory medications, PRP, viscosupplementation, supplements, and how patients can decide which activities are still worth doing when a joint becomes symptomatic. A fascinating conversation about what happens long before joint replacement—and the rapidly evolving science of preventing or slowing the path toward it.

Professor Fares Haddad joins The Joint Replacement Podcast to discuss how technology, robotics, and increasingly personalized surgical planning are changing hip and knee replacement. We explore his career across arthroplasty, complex revision surgery, elite sports, research, and editorial leadership, and how his surgical philosophy has evolved toward three-dimensional planning, cruciate preservation, partial knee replacement, and functional alignment. The centerpiece of the conversation is his recent randomized study of robotic-assisted versus conventional medial partial knee replacement. We discuss why partial knees may be particularly suited to robotics, improved implant positioning, differences in Forgotten Joint Score, criticisms of implant-to-implant comparisons, and whether increased precision is worth the added cost. We also discuss the RACER trial, mechanical versus functional alignment, why precision alone may not improve outcomes if surgeons are aiming at the wrong target, and how predictive analytics could eventually help determine patient-specific implant positioning. Finally, Professor Haddad shares his perspective as Editor-in-Chief of The Bone & Joint Journal on evaluating new evidence, answers whether robotic joint replacement is truly “better,” explains who may be a candidate for partial knee replacement, and describes why robotics may ultimately prove most valuable in complex hip and revision surgery.

“You’re too young for a joint replacement. Come back when you’re 60.” Is that still good advice? In this episode, Dr. Matthew Sloan breaks down how surgeons approach hip and knee replacement in younger patients and why chronological age is only one part of the decision. We discuss why joint replacement was historically delayed in younger patients, how modern implant materials have changed expectations for longevity, and why a patient who has surgery at 40 still needs an honest conversation about lifetime revision risk. We also explore the other side of the equation: what can happen when someone with severe arthritis spends years waiting. Loss of muscle, reduced activity, weight gain, poor sleep, inability to work or exercise, and progressive loss of quality of life all matter when deciding when surgery is appropriate. Dr. Sloan also reviews conditions frequently seen in younger patients, including hip dysplasia, femoroacetabular impingement, avascular necrosis, previous ACL or meniscus injuries, fractures, and post-traumatic arthritis. Finally, we discuss activity after joint replacement, revision surgery, and the key question younger patients should ask when they are told to wait: “What exactly are we waiting for?” The right time for joint replacement is not determined by a birthday. It is a balance between the severity of the disease, its effect on your life, the alternatives that remain, and the expected risks and benefits of surgery.

What does it really mean when your surgeon says you need “medical clearance” before a hip or knee replacement? Hospitalist and internal medicine physician Tyler Thurman, DO (@hospitaldoctort), joins The Joint Replacement Podcast to explain why physicians often prefer the term risk stratification—and what they are actually looking for before a patient goes to the operating room. We discuss cardiac risk, EKG abnormalities, blood pressure, diabetes, sodium, anemia, kidney disease, hip fracture timing, preoperative testing, and which medical problems truly justify delaying surgery. We also tackle the sometimes very different ways orthopedic surgeons and internal medicine physicians think about patients. Then things get less serious. Tyler and I go through a rapid-fire orthopedic surgery vs medicine lightning round: Why do hospitalists care so much about sodium? Which lab value do orthopedic surgeons understand the least? Who is more dangerous—an orthopedic surgeon reading an EKG or an internist reading a postoperative X-ray? And what do hospitalists actually think about all those orthopedic medical-management consults? A practical—and occasionally sarcastic—look at what really happens medically before and after joint replacement surgery.

Fifty episodes. One season. A lot of questions about how we can make joint replacement better. In this special Season One finale, Dr. Matthew Sloan looks back at the conversations, debates, patient stories, and ideas that shaped the first 49 episodes of The Joint Replacement Podcast. Hear memorable moments about deciding when it is time for joint replacement, same-day surgery, recovery after knee replacement, modern implant longevity, the surgeon becoming the patient, the RACER Knee Trial, robotic precision and alignment, complex revision surgery, periprosthetic joint infection, OR teamwork, surgical training, and the changing economics of orthopedic care. The episode closes with the lessons Matthew has taken from the first season and an invitation for listeners to help shape what comes next. Thank you to every guest, patient, surgeon, trainee, nurse, PA, surgical technologist, therapist, researcher, engineer, industry partner, listener, and viewer who helped build this community. What do you want to see in Season Two? Send us your guest suggestions, controversial topics, new technologies, research questions, patient stories, or anything else you think deserves a deeper conversation. We’re just getting started.

Dr. Andrew Schneider joins The Joint Replacement Podcast to discuss what it is really like to build a career as a young academic arthroplasty surgeon. We talk about why he chose academics, transitioning from fellowship to attending life, building a referral base, balancing clinical volume with research and teaching, working with residents and fellows as a young attending, finding mentors, developing meaningful industry collaborations, and deciding which opportunities are actually worth pursuing early in a surgical career. Dr. Schneider also shares his clinical philosophy on robotic-assisted joint replacement, why he combines robotics with kinematic alignment in total knee replacement, how he thinks about accuracy and precision in the current robotics debate, and why he believes partial knee replacement remains underutilized in appropriately selected patients. We finish with anterior versus posterior hip replacement, the future of robotic surgery, artificial intelligence, big data, and a potential future where personalized surgical planning is informed by the outcomes of thousands of patients with similar anatomy and clinical characteristics. An especially valuable conversation for orthopedic residents, adult reconstruction fellows, junior faculty, and surgeons interested in robotics and the future of arthroplasty.

What does knee replacement recovery really feel like? Diana Braun knows firsthand. After delaying surgery for nearly a decade, she ultimately underwent simultaneous bilateral total knee replacement. That experience eventually led her to co-found The Knee Zone and co-author Knee Replacement Secrets with her husband, joint replacement surgeon Dr. Raj Sinha. In this episode, Diana joins Dr. Matthew Sloan to discuss the patient side of knee replacement: how she knew it was finally time for surgery, why the mental recovery was harder than she expected, what bilateral knee replacement was really like, and why patients should think in terms of months rather than weeks when setting expectations. They also discuss sleep, prehab, swelling, compression, assistive devices, driving, stairs, preparing your home, choosing a surgeon, avoiding the temptation to do too much too soon, and the importance of identifying the activities you want to get back to before surgery. For anyone considering knee replacement, currently recovering, or caring for joint replacement patients, this conversation offers a practical and candid look at the recovery journey from someone who has lived it. For more information visit https://thekneezone.com/ You can find her book Knee Replacement Secrets on Amazon at this link: https://a.co/d/0cg5WcFp

What does it really take to match into an adult reconstruction fellowship? In Episode #47, Dr. Bill Hamilton of the Anderson Orthopaedic Clinic joins me for a practical guide for orthopedic residents preparing for fellowship. We discuss when to start preparing, what fellowship directors actually look for, research and recommendation letters, preference signaling, interview strategy, and how to build your rank list. We also explore how residents should evaluate case volume, surgical autonomy, revision exposure, fellowship culture, clinic experience, robotics, manual surgical training, and academic versus private-practice programs. Dr. Hamilton shares fascinating data from his upcoming study of the adult reconstruction fellowship match. The current environment appears increasingly applicant-friendly, with more fellowship positions available and applicants increasingly matching near the top of their rank lists. He explains why many applicants may only need 7–10 high-quality interviews rather than 15–20, and what residents should focus on instead. If you’re a PGY-2, PGY-3, or PGY-4 considering a career in hip and knee replacement, this is an episode worth saving before fellowship application season. For more information on the Learning SHAK visit https://www.learningshak.org/ Current Concepts in Joint Replacement information can be found at https://www.ccjr.com/

Maxwell Courtney, MD joins Episode 46 of The Joint Replacement Podcast for a wide-ranging conversation about arthroplasty, research, health policy, and one of the biggest challenges currently facing joint replacement surgeons. Dr. Courtney is Division Chief of Adult Reconstruction at Rothman Orthopaedics, an accomplished joint replacement surgeon and researcher, and Chair of the AAHKS Advocacy Committee. He was also my chief resident during my orthopedic training at Penn and someone I have looked up to throughout my career. We discuss Max’s path into adult reconstruction, building a successful surgical practice, mentorship, research, evidence-based medicine, and how joint replacement has transformed over the past decade through TXA, multimodal pain management, rapid recovery protocols, and outpatient surgery. Then we turn to the proposed Medicare reimbursement cuts facing total hip and knee replacement. Max explains how CMS and the AMA RUC value physician work, why increasingly efficient outpatient care has triggered another review of arthroplasty codes, and why much of the postoperative work performed by modern orthopedic teams may not be captured in the current reimbursement system. We also discuss Max’s recent trip to Washington, DC, his conversations with members of Congress, the AAHKS strategy to push back against the cuts, the potential consequences for Medicare access and private practice, and his prediction for what may happen when the final 2027 Medicare Physician Fee Schedule is released. This is an important conversation about not only what surgeons are paid, but how reimbursement policy may shape patient access, physician independence, and the future of joint replacement in the United States.

Dr. Jesse Otero, MD, PhD joins The Joint Replacement Podcast for a deep conversation about complex joint replacement, periprosthetic joint infection, research, and building a career around the patients other surgeons often find most challenging. Jesse shares the unconventional strategy he used to build a busy practice early in his career, including calling local surgeons and offering to take the revision, infection, and complex cases they did not want to manage. His first 17 cases were infected revisions, helping establish a career focused on being the surgeon other surgeons call when a case becomes difficult. He also tells the deeply personal story of his grandfather’s knee replacement complication and subsequent infection, an experience that helped redirect his career toward solving the devastating problem of PJI. We then discuss how the OrthoCarolina PJI program developed a registry containing approximately 5,500 patients, how a busy private practice can still produce high-level clinical research, and why standardizing care can transform everyday clinical practice into a research engine. Finally, Jesse breaks down their prospective randomized multicenter trial of one-stage versus two-stage exchange for chronic periprosthetic joint infection headed by his colleague Thomas K. Fehring, MD. Among 232 randomized patients, infection-free success at two years was 97% after one-stage exchange versus 91% after two-stage exchange, with the trial demonstrating noninferiority of the one-stage strategy when performed using their rigorous protocol. A fascinating discussion about surgical complexity, research, complications, resilience, and what may be the next major evolution in treating infected hip and knee replacements.

Disclosure: Dr. Matthew Sloan serves as a paid physician consultant and key opinion leader for ZetrOZ Systems, manufacturer of SAM ultrasound technology. Can sound waves actually help treat arthritis? Dr. Matthew Sloan is joined by George Lewis, PhD, CEO of ZetrOZ Systems, to discuss Sustained Acoustic Medicine (SAM) and the evolving role of therapeutic ultrasound in treating knee arthritis and musculoskeletal pain. They break down how therapeutic ultrasound differs from the ultrasound used for medical imaging, what ultrasound may be doing at the tissue level, and why delivering treatment for several hours at home is fundamentally different from the short ultrasound sessions traditionally used in physical therapy. The conversation explores who may benefit most from SAM, including patients with mild to moderate osteoarthritis, whether it has a role in bone-on-bone arthritis, and an important distinction between preserving a joint and actually regrowing cartilage. They also compare ultrasound with cortisone injections, hyaluronic acid, PRP, TENS, laser, red light, and other nonsurgical treatments; discuss its use in professional athletics; review cost and insurance coverage; and address potential risks and contraindications. Finally, Dr. Lewis shares the story behind developing a wearable therapeutic ultrasound device and his vision for where nonsurgical arthritis treatment may be headed. If you have knee arthritis and are looking for options beyond medications, injections, or surgery, this episode provides a detailed look at one of the technologies trying to fill that gap. #wearableultrasound #medtech #innovation #ultrasoundtech #kneeoa #arthritispain #painrelief

What happens when orthopedic trauma and joint replacement intersect? Dr. Matthew Sloan is joined by Dr. Alon Antebi, a fellowship-trained orthopedic trauma surgeon whose practice spans complex fractures, pelvic and acetabular trauma, primary and revision joint replacement, and outpatient surgery. Dr. Antebi discusses how surgeons decide whether to fix a hip fracture or replace the joint, when a partial versus total hip replacement may be appropriate, and why acetabular fractures present an entirely different reconstructive challenge. They also explore Dr. Antebi’s nearly two decades of experience with the direct anterior approach, his early adoption of outpatient hip and knee replacement, bilateral joint replacement, and how he selects patients for same-day surgery. The conversation goes deeper into some of the most challenging cases in orthopedics: converting previous fracture surgery to a hip replacement, dealing with retained hardware and altered anatomy, and treating patients with post-traumatic arthritis after major injuries. Finally, Dr. Antebi and Dr. Sloan discuss how joint replacement has changed over the past 20 years, the financial pressures facing orthopedic surgeons and private practices, and why patients who have been told their hip or knee is “too complicated” may benefit from seeking another opinion from a surgeon experienced in complex reconstruction. A wide-ranging conversation about trauma, joint replacement, outpatient surgery, and the evolution of modern orthopedic care.