I am an orthopaedic surgeon at Washington University in St. Louis. My practice is focused on hip and knee replacement. I also treat tendon tears on the outside of the hip and loss of blood supply to the ball of the hip joint (avascular necrosis).

I use computer navigation and robotic assistance routinely in my hip and knee replacement surgeries.

I grew up in Nashville, Tennessee. The parts of my work I enjoy most are solving difficult problems for patients, taking on complex cases, research, and teaching.

What it is

The hip is a ball and socket joint. In a total hip replacement, the worn ball at the top of the thigh bone is removed and replaced with a metal stem and a new ball. The worn socket in the pelvis is lined with a metal cup and a smooth liner. The new ball and liner glide against each other in place of the damaged joint.

Who it may help

Hip replacement is most often done for arthritis that causes pain and stiffness and has not improved enough with treatments such as medication, activity changes, physical therapy, or injections. It is also used for other conditions that damage the hip joint, including avascular necrosis.

How I do it

I use computer navigation and robotic assistance to help position the parts of the new hip according to a plan made for your anatomy.

What it is

In a total knee replacement, the worn surfaces at the end of the thigh bone and the top of the shin bone are removed and capped with metal parts. A plastic spacer sits between them and acts as the new cushion. The underside of the kneecap may also be resurfaced.

Who it may help

Knee replacement is most often done for arthritis that causes pain, stiffness, or difficulty walking and has not improved enough with treatments such as medication, activity changes, physical therapy, bracing, or injections.

How I do it

I use robotic assistance to help make the bone cuts and position the parts of the new knee according to a plan made for your knee.

What it is

The gluteus medius and gluteus minimus are muscles on the outside of the hip. They keep the pelvis level when you walk. Their tendons attach to the bony point on the outside of the hip. These tendons can wear down and tear, which may cause pain on the outside of the hip, weakness, and a limp.

In a repair, the torn tendon is brought back to the bone and held in place with strong stitches and small anchors while it heals.

Gluteus maximus transfer

Some tears cannot be repaired because the tendon has pulled too far away or the muscle no longer works well. In those cases, part of the gluteus maximus, the large muscle of the buttock, can be moved to take over the job of the torn muscle.

Who it may help

These procedures may help patients with a tendon tear seen on MRI whose pain or weakness has not improved with treatments such as physical therapy. Tears can occur in a natural hip or after a hip replacement.

What it is

Avascular necrosis, also called osteonecrosis, happens when part of the ball of the hip joint loses its blood supply. Over time the affected bone can weaken and collapse, which leads to arthritis.

In a core decompression, a small channel is drilled through the thigh bone into the affected area. This relieves pressure inside the bone and creates a path for new blood supply and healing.

Who it may help

Core decompression is used in the earlier stages of avascular necrosis, before the ball of the hip has collapsed. The goal is to preserve your natural hip and delay or avoid a hip replacement.