The Joint Replacement Podcast

Could better nutrition before surgery mean a smoother recovery afterward?In Episode 60 of The Joint Replacement Podcast, Dr. Matthew Sloan welcomes Dr. Sagar Desai, a Toronto-based orthopedic surgeon specializing in foot and ankle reconstruction and founder of Proven Therapeutics.Together, they explore an often-overlooked part of surgical preparation: nutrition.How much protein should patients eat before hip or knee replacement? Can specialized supplements reduce muscle loss or complications? Should patients really fast from midnight before surgery? And what does the evidence actually show?Dr. Desai discusses the science of immunonutrition, his experience developing a surgical nutrition supplement, and the challenges of translating research into clinical practice.The conversation also explores total ankle replacement versus ankle fusion, the controversy surrounding surgical treatment of Achilles tendon ruptures, minimally invasive bunion surgery, and the unique demands of treating professional athletes.Whether you're preparing for joint replacement, recovering from orthopedic surgery, or simply interested in optimizing surgical outcomes, this episode offers a wide-ranging discussion about preparation, recovery, and modern orthopedic care.Guest: Dr. Sagar DesaiHost: Dr. Matthew SloanLearn more at MatthewSloanMD.comEducational purposes only. Dr. Desai is the founder of Proven Therapeutics. Product-specific benefits have not been independently established in this episode.

Can an orthopedic surgeon design a better hip replacement implant than the major medical device companies?Dr. Kurtis Biggs decided to find out.In Episode 59, Dr. Matthew Sloan interviews Dr. Biggs, a fellowship-trained joint replacement surgeon from Naples, Florida, who developed his own femoral stem, taking it from a hand-drawn sketch at his kitchen counter to FDA clearance and implantation in patients.They discuss why he believed traditional hip implants could be improved, how he designed the Xerxes femoral stem to better accommodate natural hip anatomy, and the challenges of developing and manufacturing an entirely new orthopedic device.Dr. Biggs shares his early experience with approximately 130 implantations, including complications, revisions, and preliminary clinical observations.They also explore how long hip replacements really last, whether cementless or cemented stems are better, the advantages and limitations of anterior hip replacement, and how large medical device manufacturers influence which innovations reach patients.Most importantly, they confront a critical question: What evidence do we actually need before calling a new hip implant better than an established one?An inside look at surgical innovation, medical device development, and the future of hip replacement.Note: The Xerxes femoral stem has received FDA 510(k) clearance, but long-term clinical outcomes and comparative superiority remain unproven.Learn more at MatthewSloanMD.com and subscribe to The Joint Replacement Podcast for weekly conversations about hip and knee replacement.

Are health insurance companies making money by denying patients the medical care they need?Dr. Matthew Sloan welcomes Bryan Khoo, a Stanford graduate and incoming medical student at Washington University whose investigations into healthcare economics and insurance company practices have attracted national attention, including responses from Mark Cuban.They explore why American healthcare continues to become more expensive, how prior authorization decisions are made, why some insurance denials are never appealed, and the growing controversy surrounding Medicare Advantage.Bryan shares his perspectives on artificial intelligence in insurance reviews, post-surgical payment denials, corporate consolidation, physician reimbursement, and the future of independent medical practices.The conversation also examines how insurance company financial incentives may influence patient access to surgery and what reforms could help restore the physician-patient relationship.Who should control medical decisions: doctors or insurance companies?Editorial Disclaimer: Specific insurance company and healthcare business names have been redacted from portions of this interview because Dr. Sloan and The Joint Replacement Podcast have not independently verified the underlying studies, statistics, or allegations discussed. The guest's research findings and opinions are his own and should not be interpreted as independently verified conclusions or established findings of misconduct.Follow Bryan Khoo on LinkedIn and subscribe to The Joint Replacement Podcast for more conversations about healthcare, joint replacement, and medical innovation.

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.