The Joint Replacement Podcast

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.

What does a surgical technologist actually do during surgery, and how much does the team behind the surgeon affect what happens in the operating room? In this episode of The Joint Replacement Podcast, Dr. Matthew Sloan sits down with Alyssa Ellis, CST, CSFA, creator of Beyond Assisting, for a behind-the-scenes look at life in the OR. With more than 17 years of operating room experience, Alyssa explains the difference between a surgical tech and surgical first assistant, how the sterile field is created and protected, how great techs anticipate a surgeon's next move, and what separates an average surgical team from a truly high functioning one. They also tackle one of the biggest challenges facing operating rooms today: staffing. Alyssa discusses traveling surgical techs, staff turnover, training, compensation, appreciation, OR culture, and why experienced team members cannot simply be replaced without losing something important. Then the conversation turns to orthopedics: What are total hip and knee replacements like to scrub? Are revisions more fun than primary joint replacements? What makes a surgeon good to work with? What happens when something goes wrong during surgery? And if Alyssa could scrub only one operation for the rest of her career, which would she choose? Plus, the important questions: Who controls the OR music? Which specialty has the most fun? What drives surgical techs crazy? And what is the grossest operation to scrub? A fascinating look at the people patients may never remember meeting, but who play an essential role in keeping them safe during surgery.

The RACER Knee Trial is one of the most important randomized evaluations of robotic-assisted total knee replacement to date. The headline finding is provocative: robotic-assisted surgery was more precise, but patients did not report better outcomes at 12 months compared with conventional total knee replacement. But does that mean robots do not work? In this episode, I’m joined by RACER Knee investigators Professor Andy Metcalfe and Professor Ed Davis for an in-depth discussion of what the trial actually tells us. We examine the Forgotten Joint Score, statistical power, surgeon experience, alignment philosophy, MCL releases, patellar resurfacing, cemented versus cementless fixation, costs, study funding, and the difference between achieving greater precision and knowing exactly where that precision should take us. We also discuss one of the trial’s most fascinating observations: patients who believed they received robotic surgery had substantially higher Forgotten Joint Scores than those who believed they underwent conventional surgery, highlighting the importance of blinding and patient perception in surgical trials. Finally, Andy and Ed explain what they would change if RACER were designed today and preview what is coming next, including health economic analysis, learning-curve research, alignment analyses, and longer-term 2-, 5-, and 10-year follow-up. RACER may not be the end of the robotics debate. It may be the beginning of a much more interesting question: We have the ability to perform knee replacement with extraordinary precision. Now, do we know where we should put the knee?

Elizabeth Gausden, MD, joins The Joint Replacement Podcast to discuss one of the most challenging areas in orthopedic surgery: what happens when trauma and joint replacement intersect. Dr. Gausden is an orthopedic surgeon at Hospital for Special Surgery specializing in primary and revision hip and knee replacement, periprosthetic fractures, and complex reconstruction. After residency at HSS, she completed fellowship training in orthopedic trauma at UTHealth Houston and adult reconstruction at Mayo Clinic. We discuss her path to dual fellowship training, fixation versus revision for periprosthetic fractures, nail-plate constructs and distal femoral replacement, direct anterior primary and revision hip replacement, robotic-assisted hip and knee replacement, collared cementless stems, cementless knee fractures, heterotopic ossification, the Quiet Knee recovery philosophy, and how modern fixation is changing what surgeons can accomplish in increasingly complex patients. Dr. Gausden also previews the inaugural IOEN Traumaplasty Course in Orlando, October 2–3, 2026. The cadaver-based course brings trauma and arthroplasty experts together to teach practical techniques for periprosthetic fractures, revision reconstruction, and other challenging cases at the intersection of the two specialties. 🎓 FREE registration for residents and fellows Use code: TRAUMA100 Course information and registration: https://ioen.net/ioen-2026-traumaplasty-course-home/

What really happens after you leave the hospital following a knee replacement? In this episode of The Joint Replacement Podcast, I walk through the first month of recovery week by week—including the physical challenges and the psychological transition that patients may not expect. We cover: • Week 1: Survival & Stability — pain, swelling, disrupted sleep, fatigue, and learning to accept help • Week 2: Variability — why recovery isn't linear and why a bad day doesn't necessarily mean you're going backward • Week 3: The Emotional Dip — when progress can feel slow, motivation falls, and discipline becomes especially important • Week 4: Momentum — when walking, strength, pain, and confidence may begin to noticeably improve I also explain the “false plateau,” why doing too much on a good day can backfire, and why pain or swelling after increased activity can sometimes be feedback rather than failure. The first month after knee replacement isn't just physical recovery. It's a transition from dependence to independence—and from uncertainty to confidence. If you're preparing for knee replacement, recovering now, or helping someone through the process, this episode gives you a practical roadmap for those critical first four weeks. For general educational purposes only. Individual recovery varies. Always follow the recommendations of your own surgical team.

What happens when a surgeon can offer both joint preservation and joint replacement? Dr. Atul Kamath joins The Joint Replacement Podcast for a wide-ranging conversation about how modern hip and knee care has evolved—from anterior hip replacement and robotic surgery to hip arthroscopy, osteotomy, cartilage restoration, partial knee replacement, and outpatient surgery. This is also a personal episode for me: Dr. Kamath was one of my attendings during my orthopedic residency at Penn and one of the first surgeons to introduce me to the anterior approach to total hip replacement. We discuss how the anterior approach has evolved, why surgical experience and fundamentals still matter in the age of robotics, and how technology is allowing surgeons to increasingly personalize joint replacement. Dr. Kamath describes his evolution from traditional mechanical knee alignment toward a more individualized, technology-driven approach. We also take a deep dive into younger patients who aren't yet obvious candidates for joint replacement. Dr. Kamath explains the roles of hip arthroscopy, PAO, knee osteotomy, cartilage restoration, and partial knee replacement—and why the right procedure depends on much more than a patient's age. Finally, we tackle some of the questions patients ask every day: Can PRP or stem cells regrow cartilage? When is an osteotomy better than a partial knee replacement? What is the role of core decompression for avascular necrosis? And when has arthritis progressed far enough that joint replacement becomes the more predictable solution? A fascinating look at the continuum of modern hip and knee care—from preserving the native joint to replacing it. Educational content only and not a substitute for individualized medical advice.

What does better joint replacement care actually look like—and should success be measured by the surgery itself or by the health outcomes that matter most to the patient? In this episode of The Joint Replacement Podcast , Dr. Matthew Sloan speaks with Kevin Bozic, MD, MBA , Chair of the Department of Surgery and Perioperative Care at Dell Medical School at the University of Texas at Austin and former President of the American Academy of Orthopaedic Surgeons. Dr. Bozic explains why value-based healthcare should focus first on improving pain, function, and quality of life rather than simply reducing costs. He shares how his multidisciplinary practice integrates physical therapy, weight management, behavioral health, and patient-reported outcomes to manage the entire spectrum of hip and knee arthritis—not just surgery. They also explore bundled payments, Medicare reimbursement, the limitations of fee-for-service medicine, patient activation, appropriate surgical selection, and why the future may involve paying healthcare teams to manage a patient's condition rather than individual procedures. Finally, Dr. Bozic shares a unique perspective as both a joint replacement expert and a joint replacement patient himself , including how he chose his own surgeon and why he cared more about surgeon experience, volume, outcomes, facility quality, and trust than the specific implant or surgical approach. A fascinating conversation about what joint replacement looks like when we stop asking only “How do we perform surgery better?” and start asking “How do we improve the patient's health?” 🎧 Follow The Joint Replacement Podcast for weekly conversations with leaders shaping the future of hip and knee replacement. Medical Disclaimer: This podcast is for educational purposes only and is not a substitute for individualized medical advice.

What changes when a joint replacement surgeon experiences knee replacement from the other side of the operating table? Dr. Farzin Kabaei is a Los Angeles orthopedic surgeon specializing in hip and knee replacement, complex reconstruction, and orthopedic trauma. But his perspective on joint replacement is also deeply personal. After an ACL injury as a teenager, progressive arthritis, a high tibial osteotomy, multiple surgeries, and years of worsening knee pain, he ultimately underwent a knee replacement himself. In this episode, we discuss how that experience changed the way he counsels patients about pain, expectations, timing, and recovery. We explore how to know when arthritis is truly bad enough for surgery, why an X-ray alone shouldn't determine whether you need a joint replacement, and why expectations for hip and knee replacement can be very different. Dr. Kabaei also shares his approach to robotic knee replacement, anterior hip replacement and the bikini incision, injections including cortisone, hyaluronic acid and PRP, and the role of nutrition, exercise, breathwork, and preparation in recovery. Perhaps most importantly, we hear what a knee replacement actually feels like from someone who both performs the operation and lives with one every day. 🎙️ The Joint Replacement Podcast Educational content only. This podcast does not constitute individualized medical advice.

Dr. Stephen Howell is one of the pioneers of kinematic alignment in total knee replacement. In this episode, we explore his journey from ACL reconstruction research to developing one of the most influential alignment philosophies in modern arthroplasty. We discuss the biomechanics of the native knee, patient-specific instrumentation, implant design, robotics, and why restoring normal anatomy may lead to more natural-feeling knee replacements. Whether you're a patient preparing for surgery or an orthopedic surgeon interested in the evolution of knee replacement, this conversation provides an in-depth look at where the field has been—and where it's headed. Search The Joint Replacement Podcast on YouTube, Apple Podcasts, or Spotify, and don't forget to follow for future episodes. For more information about the KA-Optimized curriculum please visit https://www.kaoptimizedtka.com/

In Episode #34 of The Joint Replacement Podcast , I welcome Professor Justin Cobb from Imperial College London , one of the world's leading orthopedic innovators and pioneers in hip resurfacing and implant development. Throughout our conversation, Professor Cobb shares how engineering, biomechanics, and decades of research have shaped his approach to hip replacement and led to the development of a next-generation ceramic hip resurfacing implant. We discuss: Professor Cobb's journey into orthopedic surgery Implant design and innovation Computer-assisted surgery and robotics The evolution of hip resurfacing Ceramic-on-ceramic hip resurfacing technology Hip resurfacing versus total hip replacement Which patients may benefit most Bone preservation and athletic performance The future of joint replacement surgery If you're interested in the latest advances in hip replacement or want to understand how today's innovations may shape the future of orthopedic care, this is an episode you won't want to miss. Search The Joint Replacement Podcast on YouTube, Apple Podcasts, Spotify, or wherever you get your podcasts for more conversations with the world's leading joint replacement experts.

In Episode #33, Dr. Matthew Sloan sits down with Dr. Ran Schwarzkopf of NYU Langone Health to discuss the evolution of modern hip and knee replacement. From robotic-assisted surgery and artificial intelligence to implant longevity, revision surgery, recovery, and choosing the right surgeon, Dr. Schwarzkopf shares decades of experience caring for complex joint replacement patients while offering practical advice for anyone considering surgery. Whether you're a patient, surgeon, trainee, or simply interested in the future of orthopedic surgery, this episode offers an inside look at where joint replacement is headed—and what it means for patients today.

Dr. Jeremy Gililland is Professor of Orthopedic Surgery and Chief of Adult Reconstruction at the University of Utah. With a unique background in mechanical engineering before medicine, he brings an engineer's mindset to some of the most complex problems in hip and knee replacement surgery. In this episode of The Joint Replacement Podcast , Dr. Matthew Sloan and Dr. Gililland discuss: How designing bicycles led him to orthopedic surgery Why anterior hip replacement has become his preferred approach The evolution of complex anterior revision surgery Engineering innovations that led to the development of fluoroscopic navigation technology The future of robotics versus manual surgery Cemented vs. cementless fixation Hip fracture treatment and total hip replacement Research collaborations shaping modern arthroplasty How he trains residents and fellows in academic medicine Recovery timelines after hip and knee replacement When patients should consider joint replacement Advice every patient should know before choosing a surgeon Whether you're a patient considering hip or knee replacement, an orthopedic surgeon, resident, fellow, or simply interested in the future of orthopedic innovation, this episode is packed with practical insights and thoughtful discussion. 📺 Watch on YouTube: https://youtu.be/ 🎙️ Search "The Joint Replacement Podcast" wherever you get your podcasts. 👍 If you enjoyed this episode, please like, subscribe, comment, and share—it helps us reach more patients and healthcare professionals. #JointReplacement #HipReplacement #KneeReplacement #OrthopedicSurgery #AnteriorHipReplacement

Dr. Blake Peterson joins The Joint Replacement Podcast for an in-depth conversation on modern hip and knee replacement, building a successful private practice, and where orthopedic surgery is headed next. We discuss surgical mentorship, managing complications, robotics, functional alignment, ambulatory surgery centers, physician reimbursement, research, efficiency in the operating room, and how emerging technologies—including AI and autonomous robotics—may reshape joint replacement over the next decade. Whether you're an orthopedic surgeon, trainee, or patient interested in the future of joint replacement, this episode delivers practical lessons from one of the country's most thoughtful innovators in adult reconstruction. 🎧 Search The Joint Replacement Podcast on YouTube, Spotify, Apple Podcasts, or wherever you listen to podcasts.

Can patients undergo hip or knee replacement without needing opioids afterward? In Episode #30, Dr. Matthew Sloan welcomes fellowship-trained adult reconstruction surgeon Dr. Andrew Wickline to discuss how modern recovery protocols are changing one of the biggest challenges in orthopedic surgery: postoperative pain. Dr. Wickline explains how reducing swelling, limiting unnecessary physical therapy, optimizing patient education, and using evidence-based multimodal pain strategies have allowed most of his patients to recover with little or no opioid use. He also shares lessons learned throughout his career, why surgeons should rigorously track their own outcomes, and how continuous improvement has transformed both his practice and his patients' recoveries. Topics include: Opioid-free joint replacement Multimodal pain management Step count recovery protocols Physical therapy after knee replacement Compression and cryotherapy Extended tranexamic acid Same-day joint replacement Patient education Recovery optimization Surgical outcomes and data collection Lessons from two decades in arthroplasty Whether you're a patient considering surgery or an orthopedic professional looking to optimize recovery, this conversation offers practical insights into where joint replacement is headed next. 🔎 Search "The Joint Replacement Podcast" wherever you get your podcasts! 🎙️ www.AndrewWicklineMD.com ❤️ If you enjoyed this episode, please leave a rating, share it with a friend, and help us continue improving the reach of evidence-based joint replacement education! 🙌

Dr. Eric Cohen, adult reconstruction surgeon at Brown University Health and Assistant Professor at the Warren Alpert Medical School of Brown University, joins The Joint Replacement Podcast for an in-depth discussion on how modern joint replacement continues to evolve. We discuss: The rise of same-day hip and knee replacement How COVID transformed arthroplasty care Who can safely go home the day of surgery Patient optimization before surgery Activity restrictions and returning to sports Robotic-assisted joint replacement Artificial intelligence and the future of orthopedic surgery New non-opioid pain management strategies Preventing infection after joint replacement Recovery timelines and manipulation after knee replacement Choosing the right joint replacement surgeon The future of education and training in arthroplasty Dr. Cohen also shares his perspective on complex revision surgery, advances in recovery protocols, and why helping patients regain their quality of life continues to be the most rewarding part of his career. 🎧 Search "The Joint Replacement Podcast" wherever you listen to podcasts for more conversations with the world's leading hip and knee replacement surgeons.

Dr. Matthew Sloan welcomes Dr. H. John Cooper , adult reconstruction and revision joint replacement surgeon at Columbia University Irving Medical Center, for an in-depth conversation on the present and future of hip and knee replacement. Dr. Cooper discusses his journey from biomedical engineering to orthopedic surgery, managing complex revision cases, robotic-assisted knee replacement, anterior hip replacement, infection treatment strategies, and the evolving role of AI in orthopedic practice. The conversation also covers: Revision hip and knee replacement One-stage exchange for infection Robotic knee replacement Kinematic alignment Bikini anterior hip approach Patellar resurfacing Modern pain management Physical therapy after joint replacement Implant longevity Returning to sports Choosing the right surgeon Future technologies in arthroplasty Whether you're a patient preparing for surgery, recovering from a joint replacement, or an orthopedic professional looking for expert perspectives, this episode offers valuable insights into modern hip and knee replacement care. Subscribe to The Joint Replacement Podcast for weekly conversations with leaders shaping the future of joint replacement surgery.

Why are so many patients walking just hours after hip or knee replacement surgery? The answer isn't simply better implants or robotic technology—it's the dramatic evolution of modern anesthesia and perioperative medicine. In Episode 27, Dr. Matthew Sloan explores how multimodal pain management, spinal anesthesia, targeted nerve blocks, opioid minimization, and coordinated recovery protocols have fundamentally changed the patient experience after joint replacement. Topics include: The shift from heavy sedation to precision-guided anesthesia How spinal anesthesia improves recovery Why nerve blocks preserve strength while reducing pain The concept of preemptive analgesia How robotic surgery complements modern recovery pathways Why early mobility is beneficial—but doesn't mean you're fully healed The role of personalized anesthesia plans Whether you're considering surgery or simply want to understand how modern joint replacement has evolved, this episode explains the science behind today's faster, safer, and more comfortable recoveries. The Joint Replacement Podcast delivers evidence-based education on robotic joint replacement, recovery science, implant technology, and the future of orthopedic surgery.