Procedures Covered on This Page
Total Knee Replacement
Total knee replacement (TKR) — also called total knee arthroplasty — is a procedure in which the damaged cartilage and bone surfaces of the knee are removed and replaced with a smooth metal and plastic implant. It is designed to recreate the natural motion of a healthy knee and is most commonly performed for severe knee arthritis that no longer responds to conservative treatment. The vast majority of patients experience dramatic pain relief and return to activities they had given up for years.
Who Is a Candidate?
- Severe knee osteoarthritis causing daily pain, stiffness, or disability
- Pain that wakes you at night or limits walking to less than one block
- Failed non-surgical treatments: PT, injections, bracing, weight loss
- Significant knee deformity (bow-legged or knock-kneed)
- Inflammatory arthritis (rheumatoid, psoriatic) with joint destruction
What the Surgery Involves
- Damaged cartilage and a thin layer of bone are removed from the knee
- Metal components are secured to the femur (thigh bone) and tibia (shin bone)
- A medical-grade plastic (polyethylene) spacer creates a smooth gliding surface
- The kneecap surface may be resurfaced as well
- Most patients walk the same day as surgery
Modern Implant Technology
Today's knee implants are designed to closely mimic natural knee mechanics and are built to last 20–25+ years in most patients. Advanced bearing surfaces reduce wear, and robotic-assisted surgery allows for exceptional precision in implant positioning — which directly impacts how long the implant lasts and how well the knee feels.
Total knee replacement has a patient satisfaction rate of over 90%, and modern implants are expected to last 20+ years in the majority of patients. Studies consistently show that TKR significantly reduces pain, improves function, and dramatically improves quality of life compared to continued non-surgical management of severe arthritis.
Before & After Surgery
Before Surgery (Preparing for Success)
- Pre-operative PT strengthens muscles before surgery ("prehab")
- Medical optimization: blood pressure, blood sugar, weight
- Dental work and skin infections must be addressed before surgery
- Blood thinners or certain medications may need to be adjusted
- Arrange home support for the first 2–4 weeks
After Surgery (Recovery)
- Walking with assistance on the day of surgery
- Home with a cane or walker within 1–3 days (outpatient or short stay)
- Formal PT for 6–12 weeks to restore strength and motion
- Blood clot prevention: medication and compression devices
- Most patients return to golf, swimming, and cycling within 3 months
Wondering if your knee pain has reached the point where replacement is the right option? Schedule a consultation with Dr. McLaughlin for a complete evaluation.
Request a ConsultationPartial Knee Replacement (Unicompartmental)
The knee has three compartments: the inner (medial), outer (lateral), and front (patellofemoral). When arthritis affects only one of these compartments and the rest of the knee is healthy, a partial knee replacement — also called a unicompartmental or "uni" knee replacement — may be a better option than replacing the entire joint. Partial replacement preserves more bone and natural tissue, often resulting in a knee that feels more natural and a faster recovery.
Who Is a Candidate for Partial Knee?
- Arthritis isolated to one compartment (usually the medial/inner side)
- Healthy cartilage confirmed in the other compartments on MRI or scope
- Intact cruciate ligaments (ACL and PCL)
- No severe deformity of the knee
- Generally best for less heavy-set, active patients with specific pain patterns
Advantages Over Total Knee
- Smaller incision and less blood loss
- Faster recovery — many patients go home the same day
- More natural knee feel — normal ligaments are preserved
- Less bone removed — easier to convert to total knee if needed later
- Range of motion often better than total knee replacement
Partial knee replacement is not the right choice for everyone — but for the right patient, outcomes are excellent, with survivorship rates comparable to total knee replacement at 10–15 years. The key is precise patient selection, which requires careful evaluation of X-rays, MRI, and physical examination findings.
Surgical Approach
The Procedure
- Small incision (about 3–4 inches) on the affected side of the knee
- Only the damaged cartilage and bone are removed
- Metal and plastic implant resurfaces that compartment only
- Ligaments and other compartments remain completely intact
Recovery Highlights
- Walking same day as surgery with minimal assistance
- Many patients discharged home 4–6 hours after surgery
- PT begins within days — faster progression than total knee
- Driving as early as 2–3 weeks post-op (right leg surgery)
- Return to golf, hiking, and sport: 6–10 weeks
Total Hip Replacement
Total hip replacement (also called total hip arthroplasty) is one of the most successful surgical procedures in the history of modern medicine. In this procedure, the arthritic ball and socket of the hip joint are replaced with metal, ceramic, and plastic components that restore smooth, pain-free movement. Patients who have been limited by hip pain for years often describe the results as life-changing — the ability to walk without a limp, sleep through the night, and return to activities they love.
Who Is a Candidate?
- Hip osteoarthritis causing pain, stiffness, and difficulty walking
- Hip pain that does not improve with rest, PT, or injections
- Avascular necrosis (bone death of the femoral head)
- Fracture of the femoral head or neck in older patients
- Inflammatory arthritis with significant joint destruction
- Hip dysplasia with secondary arthritis
What the Surgery Involves
- The arthritic femoral head (ball) is removed
- A titanium stem is placed in the femur with a ceramic or metal ball on top
- The damaged socket (acetabulum) is prepared and a metal cup is press-fit in
- A plastic or ceramic liner inside the cup creates the smooth gliding surface
- Most modern implants are cementless (bone grows into the implant)
Anterior vs. Posterior Approach
There are several surgical approaches to hip replacement. Dr. McLaughlin will discuss which approach is best suited to your anatomy and goals. The anterior (front) approach may allow faster recovery and reduced dislocation risk for appropriate patients, while the posterior approach offers excellent visualization and is preferred in complex cases. Both approaches produce outstanding outcomes in experienced hands.
Total hip replacement has a patient satisfaction rate of over 95% — making it among the highest-rated procedures in all of surgery. Modern implants last 20–30 years in most patients. The majority of patients walk with a cane within days and are back to golf, swimming, and travel within 2–3 months.
Before & After Surgery
Preparing for Surgery
- Pre-operative strengthening exercises for hip abductors and quadriceps
- Medical optimization (heart health, diabetes, blood pressure)
- Dental care and skin infection clearance before surgery
- Home modifications: raised toilet seat, shower chair, grab bars
- Arrange transportation and home help for the first 2–4 weeks
After Surgery (Recovery)
- Walking with a walker on the day of surgery
- Most patients go home within 1–2 days (many go home same day)
- Hip precautions for 6 weeks (avoiding certain movements that risk dislocation)
- PT focuses on gait training, hip strengthening, and balance
- Blood clot prevention is a key part of post-operative care
Hip pain that limits your daily life is not something you have to accept. A consultation with Dr. McLaughlin can help you understand all of your options.
Request a ConsultationTotal Shoulder Replacement (Anatomic)
Anatomic total shoulder replacement replaces the damaged ball and socket of the shoulder with components that closely mimic the natural anatomy — a metal ball on the humerus (arm bone) and a plastic socket on the glenoid (shoulder blade). This procedure is specifically designed for patients who have significant shoulder arthritis but still have an intact, functional rotator cuff. It produces excellent pain relief and allows most patients to return to overhead activities, golf, tennis, and work.
Who Is a Candidate?
- Shoulder osteoarthritis with intact rotator cuff tendons
- Persistent pain, stiffness, and limited overhead motion
- Failed conservative treatment: PT, anti-inflammatory medications, injections
- Avascular necrosis (bone death) of the humeral head
- Post-traumatic arthritis after previous shoulder fracture
What the Surgery Involves
- The arthritic humeral head (ball) is removed and replaced with a metal implant
- The socket (glenoid) is prepared and a plastic component is secured
- The rotator cuff tendons are carefully protected and repaired if needed
- Both cemented and cementless (bone ingrowth) glenoid options are available
- Performed as an outpatient or 1-night stay depending on patient factors
Washington University Training
Dr. McLaughlin completed his fellowship at Washington University in St. Louis — one of the nation's premier shoulder surgery programs. This training gives him specialized expertise in anatomic total shoulder replacement, including the latest implant systems, glenoid fixation techniques, and approaches to restoring natural shoulder mechanics. Both primary and complex cases are within his scope of practice.
Shoulder replacement is the fastest-growing joint replacement procedure in the United States. Studies show that over 95% of patients experience significant pain relief, and the majority return to recreational sports, swimming, and overhead work. Implant survivorship is excellent at 10–15 years.
Surgery & Recovery Overview
Immediate Post-Operative
- Arm in a sling for 4–6 weeks to protect the repair
- Pendulum exercises begin within days to prevent stiffness
- Ice and elevation to manage swelling
- Pain well-controlled with oral medications and nerve block
- Most patients sleep in a recliner for the first 2–4 weeks
Progressive Recovery
- Passive PT (therapist moves the arm): weeks 2–6
- Active range of motion begins: around week 6
- Strengthening exercises: months 3–6
- Return to golf, tennis, swimming: 4–6 months
- No heavy lifting (over 20–25 lbs) permanently recommended
Reverse Total Shoulder Replacement
The reverse total shoulder replacement is one of the most important advances in orthopaedic surgery of the last 30 years. Unlike a traditional shoulder replacement — which relies on the rotator cuff to lift the arm — the reverse design literally "reverses" the ball and socket: the ball is placed on the socket side (shoulder blade) and the socket on the ball side (arm). This clever redesign means the large deltoid muscle takes over arm elevation, making it ideal for patients with massive rotator cuff tears, complex fractures, and other conditions where the rotator cuff is not functional.
Who Is a Candidate?
- Massive, irreparable rotator cuff tears with significant weakness
- Rotator cuff tear arthropathy (arthritis combined with cuff failure)
- Severe shoulder fractures in older patients (proximal humerus fractures)
- Failed prior shoulder replacement or instability
- Significant arthritis with a non-functional rotator cuff
- Tumors around the shoulder joint
How the Reverse Design Works
- A metal ball (glenosphere) is fixed to the shoulder blade (glenoid)
- A plastic socket (polyethylene cup) is placed on the arm bone (humerus)
- This shifts the center of rotation, allowing the deltoid to lift the arm
- No reliance on the rotator cuff — damaged tendons are bypassed
- Arm elevation is typically restored to shoulder height or above
Dr. McLaughlin's Specialty
Reverse shoulder replacement is a technically demanding procedure that requires fellowship-level training and high surgical volume. Dr. McLaughlin performs reverse shoulder replacement as a core part of his practice, with expertise in both primary cases and complex revisions. His training at Washington University — one of the nation's leading shoulder programs — provides a strong foundation in the latest reverse shoulder techniques and implant systems.
Studies show that reverse shoulder replacement reliably restores the ability to lift the arm above the head in patients who previously had severe weakness or pseudoparalysis. Patient satisfaction rates exceed 90%, and the procedure has transformed outcomes for patients who previously had no good surgical options.
Surgery & Recovery Overview
Immediate Post-Operative
- Arm in a sling for 4–6 weeks
- Pendulum and passive stretching exercises begin early
- Pain is often less than patients expect — modern nerve block protocols help
- Patients go home same day or after one night
- Regular follow-up with imaging at key intervals
Progressive Recovery
- Active forward elevation exercises: beginning at 6 weeks
- Formal PT: 6 weeks through 4–6 months
- Internal rotation and rotational strength are more limited than anatomic replacement
- Activities of daily living typically restored by 3–4 months
- Overhead reaching and light sport: 4–6 months
Shoulder pain from rotator cuff failure or arthritis doesn't have to define your life. Reverse shoulder replacement may restore the arm function you've been missing.
Request a ConsultationRevision Joint Replacement
Joint replacement implants are built to last, but no implant lasts forever. Over time — or sometimes sooner due to complications — a previously placed implant may need to be removed and replaced. This is called a revision joint replacement. Revision surgery is significantly more complex than a primary replacement: the old implant must be carefully removed, bone loss must be addressed, and the new implant must be securely anchored in a more challenging environment. Outcomes in revision surgery are very good when performed by an experienced specialist.
Common Reasons for Revision Surgery
- Implant wear and loosening over time (the most common reason)
- Infection of the joint replacement (periprosthetic joint infection)
- Instability or dislocation — the joint keeps dislocating
- Periprosthetic fracture — a fracture of the bone around the implant
- Stiffness (arthrofibrosis) that limits motion despite therapy
- Implant failure or malposition from the original surgery
What Makes Revision Surgery Different
- Old cement, implant components, and bone ingrowth must be carefully removed
- Bone loss is common and may require bone graft or specialized implants
- Higher complexity than primary replacement
- Infection cases often require a two-stage approach: removing implant first, then reimplanting after antibiotic treatment
- Recovery is typically longer than a first-time replacement
Periprosthetic joint infection (PJI) — infection of a joint replacement — requires aggressive and specialized treatment. In most cases, a two-stage revision is required: removing all implant components and placing an antibiotic spacer for 6–12 weeks, then reimplanting a new joint after infection is cleared. Early diagnosis is critical. If you have increasing pain, swelling, warmth, or drainage around a joint replacement, contact our office promptly.
Revision Surgery — What to Expect
Evaluation & Planning
- Comprehensive X-ray and CT scan assessment of implant and bone stock
- Blood tests and joint aspiration if infection is suspected
- Detailed surgical planning — often with implant-specific custom templates
- Pre-operative medical optimization is especially important in revision cases
- Consultation with infectious disease specialists if infection is present
Surgery & Recovery
- Higher complexity than primary replacement; typically requires a brief hospital stay
- Typically requires a brief hospital stay (1–3 nights)
- PT follows a modified, more gradual protocol than primary replacement
- Weight-bearing restrictions may apply depending on bone quality
- Results are excellent when appropriate treatment and timing are used
Experiencing pain, swelling, or instability around a prior joint replacement? An evaluation with Dr. McLaughlin can determine the cause and the best path forward.
Request a ConsultationHow Do I Know If I'm Ready for Joint Replacement?
Joint replacement is never an emergency — but waiting too long can allow bone loss and muscle weakness to accumulate, making surgery more complex. The right time is when your quality of life is significantly affected and non-surgical options are no longer providing meaningful relief.