Total Joint Replacement Surgery in Northern Virginia
Specialized hip, knee, and shoulder replacement care for patients with advanced arthritis or joint damage, with treatment focused on reducing pain, restoring function, and helping you return to the activities that matter most.
Joint Replacement at a Glance
Procedure: Surgery that replaces damaged joint surfaces with artificial components
Joints We Treat: Hip, knee, and shoulder
Common Reasons for Surgery: Advanced osteoarthritis, post-traumatic arthritis, avascular necrosis, and other conditions causing severe joint damage
Hip & Knee Replacement Surgeon: Randall S. Peyton, MD
Shoulder Replacement Surgeon: Matthew H. Griffith, MD
Joint Replacement Consultations: Sterling, Virginia
Rehabilitation: Physical therapy and postoperative rehabilitation are available through Arthritis & Sports
Goal: Reduce joint pain and improve mobility and everyday function
What Is Total Joint Replacement?
Total joint replacement, also called total joint arthroplasty, is surgery used to replace damaged surfaces within a joint with artificial components.
Despite the name, the surgeon does not simply remove the entire joint.
Instead, damaged bone and cartilage surfaces are carefully prepared and replaced with components designed to recreate the movement and function of the joint.
The exact procedure is different for the hip, knee, and shoulder because each joint has a different anatomy.
Joint replacement is generally considered when significant joint damage causes persistent pain, stiffness, or loss of function and appropriate nonsurgical treatments no longer provide enough relief.
Why Is Joint Replacement Performed?
The most common reason for joint replacement is advanced arthritis.
Healthy cartilage allows joint surfaces to move smoothly against one another. When cartilage becomes significantly damaged, movement can become painful and the joint may become increasingly stiff.
Over time, patients may have difficulty:
walking
climbing stairs
standing from a chair
reaching or lifting
exercising
sleeping comfortably
working
or performing normal everyday activities
The decision to have joint replacement should be based on how the condition affects your life as well as examination and imaging findings.
An abnormal X-ray alone does not automatically mean you need surgery.
Learn more about arthritis treatment.
What Conditions May Lead to Joint Replacement?
Several conditions can cause enough joint damage that replacement may eventually be considered.
Osteoarthritis
Osteoarthritis is the most common reason for hip and knee replacement and is also an important cause of shoulder replacement.
As joint cartilage and other tissues change over time, patients may develop progressive pain, stiffness, swelling, reduced motion, and difficulty with normal activities.
Many patients manage osteoarthritis without surgery for years.
Replacement becomes a consideration when symptoms and joint damage become severe enough that nonsurgical treatment no longer provides adequate relief.
Post-Traumatic Arthritis
A significant fracture, ligament injury, dislocation, or other joint trauma can alter the joint and eventually contribute to arthritis.
Post-traumatic arthritis may develop years after the original injury.
Treatment depends on the joint, degree of damage, age, function, and previous procedures.
Avascular Necrosis
Avascular necrosis, also called osteonecrosis, occurs when blood supply to part of a bone is disrupted.
When this affects the end of a bone that forms a joint, the bone can weaken or collapse and lead to significant joint damage.
Joint replacement may be considered when the condition becomes advanced.
Inflammatory Arthritis
Conditions such as rheumatoid arthritis can damage joints over time.
The underlying inflammatory disease is generally managed medically, often with a rheumatologist.
Orthopedic surgery may be considered when a specific joint develops severe structural damage, pain, or loss of function despite appropriate treatment.
When Should You Consider Joint Replacement?
There is no single symptom, age, or X-ray finding that determines when someone should have a joint replacement.
A consultation may be appropriate when:
joint pain is persistent or severe
stiffness significantly limits movement
walking or everyday activities have become difficult
pain interferes with sleep
your independence is decreasing
you have stopped activities that are important to you
nonsurgical treatments no longer provide enough relief
or joint damage is significantly affecting quality of life
Meeting with a joint replacement surgeon does not commit you to surgery.
The consultation is an opportunity to understand the condition of the joint, review nonsurgical and surgical options, and decide whether surgery makes sense now or could become appropriate later.
What Treatments Are Usually Tried Before Joint Replacement?
For many patients with arthritis, treatment begins without surgery.
Options vary by joint and diagnosis and may include:
exercise
physical therapy
temporary activity modification
medication when appropriate
weight management when appropriate
braces or supportive devices
and selected injections
Not every patient needs to try every available treatment.
Treatment should be individualized based on the affected joint, severity of symptoms, overall health, and whether a particular option is likely to provide meaningful benefit.
Explore our non-surgical orthopedic treatments.
What Joints Can Be Replaced?
At Arthritis & Sports, our joint replacement specialists provide hip, knee, and shoulder replacement care.
Each type of replacement has its own surgical techniques, implant designs, rehabilitation needs, and expected recovery.
Total Hip Replacement
The hip is a ball-and-socket joint.
During total hip replacement, the damaged femoral head at the top of the thigh bone is replaced with an artificial ball and stem.
The damaged surface of the hip socket is also prepared and fitted with an artificial socket component.
Hip replacement is commonly performed for advanced osteoarthritis and other conditions that cause severe hip-joint damage.
The goal is to reduce pain and restore comfortable movement and function.
Explore hip pain and orthopedic hip care.
Anterior Hip Replacement
Total hip replacement can be performed using several surgical approaches.
Randall S. Peyton, MD, has extensive experience with the direct anterior approach.
The anterior approach accesses the hip from the front using an intermuscular pathway.
It may offer certain early recovery advantages for appropriately selected patients, but no surgical approach is automatically best for every patient.
Dr. Peyton can determine which approach is most appropriate based on your anatomy, diagnosis, prior surgery, overall health, and individual needs.
Learn more about anterior hip replacement.
Total Knee Replacement
During total knee replacement, damaged cartilage and a small amount of underlying bone are removed from the ends of the femur and tibia.
The surfaces are then fitted with metal components, and a durable plastic insert creates the new bearing surface between them.
The kneecap may also be addressed depending on the individual procedure.
Knee replacement is most commonly considered for advanced knee arthritis that causes persistent pain and functional limitations despite appropriate nonsurgical treatment.
Explore knee pain and orthopedic knee care.
Partial Knee Replacement
Not every patient with knee arthritis requires replacement of all joint surfaces.
When arthritis is limited to one compartment of the knee and other structures remain healthy enough, partial knee replacement may be an option for selected patients.
Only the damaged portion of the knee is resurfaced.
Candidacy depends on the location of arthritis, ligament stability, alignment, symptoms, and other individual factors.
Total Shoulder Replacement
Shoulder replacement may be considered when severe arthritis or another condition causes significant shoulder pain, stiffness, and loss of function.
In a traditional anatomic total shoulder replacement, the damaged ball at the top of the upper-arm bone is replaced with an artificial component and the damaged socket is resurfaced.
The condition of the rotator cuff is an important factor when determining which type of shoulder replacement is most appropriate.
Matthew H. Griffith, MD, specializes in shoulder replacement and advanced shoulder reconstruction.
Explore shoulder pain and orthopedic shoulder care.
Reverse Shoulder Replacement
Reverse total shoulder replacement changes the normal ball-and-socket orientation of the shoulder.
An artificial ball is attached to the shoulder-blade side of the joint and a socket component is placed on the upper-arm side.
This changes the mechanics of the shoulder and allows the deltoid muscle to play a larger role in raising the arm.
Reverse shoulder replacement may be considered for selected patients with severe arthritis combined with significant rotator cuff dysfunction, certain complex fractures, failed previous shoulder surgery, or other conditions.
The appropriate procedure depends on the condition of the joint and surrounding muscles and tendons.
Partial vs. Total Joint Replacement
The word “total” does not mean that every patient with arthritis needs the entire joint replaced.
In selected situations, only the damaged portion of a joint may need to be resurfaced or replaced.
Partial knee replacement is one example.
Certain shoulder conditions may also be treated with partial replacement procedures.
Whether partial or total replacement is appropriate depends on where the damage is located and the condition of the remaining joint.
Your surgeon will recommend the procedure that best matches your anatomy and diagnosis.
What Happens Before Joint Replacement Surgery?
Preparing for joint replacement begins well before the day of surgery.
Your care team may review:
your medical history
medications and supplements
previous surgeries
current health conditions
imaging
home support
mobility needs
and plans for postoperative rehabilitation
Medical clearance or additional testing may be recommended depending on your health.
You will also receive instructions regarding medications, eating and drinking before surgery, transportation, and preparing your home for recovery.
Joint Replacement Education
Knowing what to expect can make the surgical process easier to navigate.
Arthritis & Sports offers a complimentary Joint Replacement Class for upcoming joint-replacement patients.
The class reviews preparation for surgery, what to expect around the procedure, rehabilitation, and recovery.
Learn more about our Joint Replacement Class.
What Happens During Joint Replacement Surgery?
The details vary significantly between hip, knee, and shoulder replacement.
In general, the surgeon:
accesses the damaged joint
removes or prepares the damaged joint surfaces
positions the appropriate artificial components
checks alignment, stability, movement, and implant positioning
and closes the surgical area
The specific implant and surgical technique are selected based on the joint, anatomy, diagnosis, bone quality, and other individual factors.
Your surgeon will explain your specific procedure before surgery.
What Are the Risks of Joint Replacement?
Joint replacement is major orthopedic surgery.
Potential risks can include:
infection
blood clots
bleeding
fracture
nerve or blood-vessel injury
stiffness
continued pain
wound problems
instability or dislocation
implant loosening or wear
differences in limb length in certain procedures
and medical or anesthesia-related complications
Risks differ somewhat between hip, knee, and shoulder replacement.
Your individual risk also depends on your health, medications, bone quality, previous surgeries, and other factors.
Your surgeon will discuss the expected benefits, risks, limitations, and alternatives before surgery.
What Is Recovery Like After Joint Replacement?
Recovery is different for every patient and every joint.
A hip replacement does not have the same recovery as a knee or shoulder replacement.
Age, health, preoperative strength, the type of surgery, home support, and rehabilitation can all influence progress.
Early Recovery
Patients are generally encouraged to begin appropriate movement relatively early after joint replacement.
After hip or knee replacement, walking often begins soon after surgery with assistance.
After shoulder replacement, the arm may need to be protected in a sling while healing begins.
Pain and swelling are expected during early recovery and gradually improve over time.
Physical Therapy
Rehabilitation helps restore movement, strength, function, and confidence after surgery.
The specific program depends on the replaced joint.
Hip and knee rehabilitation commonly focuses on walking, strength, balance, mobility, and gradually increasing activity.
Shoulder rehabilitation progresses according to the surgical procedure and healing of the surrounding soft tissues.
Learn more about physical therapy at Arthritis & Sports.
Returning to Everyday Activities
Return to driving, work, exercise, travel, and other activities varies.
Some activities return within weeks, while strength, endurance, mobility, and confidence can continue improving for months.
Your surgeon and rehabilitation team will guide your progression rather than relying on a single recovery timeline for every patient.
Read our hip replacement recovery timeline.
How Long Does a Joint Replacement Last?
There is no exact expiration date for an artificial joint.
Modern joint replacements are designed to function for many years, but implant longevity varies.
Factors can include:
the joint replaced
implant type
age at surgery
activity level
body weight
bone quality
surgical factors
and complications such as infection or instability
Some implants eventually loosen, wear, or develop another problem that requires revision surgery.
Long-term follow-up with your orthopedic surgeon can help monitor the replacement over time.
What Is Revision Joint Replacement?
Revision joint replacement is surgery performed when an existing artificial hip or knee develops a problem that requires another operation.
Reasons can include:
implant loosening or wear
infection
instability or dislocation
fracture around the implant
or another mechanical problem
Revision surgery can be more complicated than the original replacement because of scar tissue, bone loss, previous implants, or infection.
Dr. Randall Peyton has specialized experience in primary and complex revision hip and knee replacement.
Learn more about revision hip and knee replacement.
Which Arthritis & Sports Joint Replacement Specialist Should I See?
The appropriate surgeon depends primarily on which joint is affected.
Randall S. Peyton, MD — Hip & Knee Replacement
Randall S. Peyton, MD, is a board-certified orthopaedic surgeon specializing in adult hip and knee reconstruction and joint replacement.
His expertise includes:
total hip replacement
anterior hip replacement
total knee replacement
partial knee replacement
and complex revision hip and knee replacement
Dr. Peyton has performed thousands of hip and knee replacements and teaches joint-replacement techniques through surgeon education programs.
He sees patients at our Sterling office.
Matthew H. Griffith, MD — Shoulder Replacement
Matthew H. Griffith, MD, is a board-certified orthopaedic surgeon with fellowship training in sports medicine and shoulder surgery.
His shoulder expertise includes:
total shoulder replacement
reverse shoulder replacement
advanced shoulder reconstruction
and treatment of other degenerative, traumatic, and sports-related shoulder conditions
Dr. Griffith sees patients at our Sterling office.
Joint Replacement Care in Sterling, Virginia
Our current hip, knee, and shoulder replacement specialists see patients at our Sterling orthopedic office.
Arthritis & Sports Orthopaedics
21475 Ridgetop Circle
Suite 150
Sterling, VA 20166
Patients visit us from throughout Loudoun County and Northern Virginia, including Sterling, Ashburn, Leesburg, Reston, Herndon, Chantilly, South Riding, Aldie, and surrounding communities.
Physical therapy and postoperative rehabilitation are also available through Arthritis & Sports.
Frequently Asked Questions About Joint Replacement
How do I know if I need a joint replacement?
There is no single test that determines when someone needs joint replacement. Surgery is generally considered when significant joint damage causes persistent pain or loss of function and appropriate nonsurgical treatment no longer provides enough relief. Your symptoms, examination, X-rays, health, goals, and quality of life all matter.
Am I too young or too old for joint replacement?
Age alone does not determine whether joint replacement is appropriate. Your surgeon considers the severity of joint damage, symptoms, health, activity needs, bone quality, and expected risks and benefits. Because implants may eventually require revision, age and expected lifetime use are still part of the discussion.
Does joint replacement mean the entire joint is removed?
No. Joint replacement involves removing or resurfacing damaged joint surfaces and replacing them with artificial components. The exact amount of bone and tissue addressed depends on the joint and procedure.
Do I have to try injections before joint replacement?
Not necessarily. Treatment should be individualized. Many patients try several nonsurgical approaches before surgery, but there is no rule requiring every patient to complete every available treatment. Your surgeon can explain which options make sense for your particular joint and stage of arthritis.
Is joint replacement an outpatient procedure?
Some appropriately selected patients can return home the same day as certain joint-replacement procedures. Others may require hospital observation or a longer stay depending on the procedure, health, support at home, and recovery immediately after surgery. Your surgical team will determine the appropriate setting for you.
How painful is joint replacement recovery?
Pain and soreness are expected after joint replacement, particularly during the early recovery period. Modern pain-management strategies use several approaches to help control symptoms while patients begin moving and rehabilitating. Pain experiences vary significantly by patient and procedure.
Will I need physical therapy after joint replacement?
Rehabilitation is an important part of recovery, although the exact program varies by joint. Hip, knee, and shoulder replacement each have different rehabilitation needs. Your surgeon and therapy team will provide instructions based on your procedure and progress.
Can I return to exercise after joint replacement?
Many patients return to regular recreational activity after recovery. The types of exercise recommended depend on the replaced joint, implant, health, experience, and activity demands. Low-impact activities are commonly encouraged after hip and knee replacement. Discuss higher-impact or sport-specific activities with your surgeon.
Can a joint replacement be replaced again?
Yes. When a hip or knee replacement develops a significant problem, revision surgery may be possible. Revision procedures are generally more complex than first-time joint replacement and require careful evaluation. Learn more about revision joint replacement.
Schedule a Joint Replacement Consultation
If arthritis or joint damage is making it increasingly difficult to walk, sleep, exercise, work, reach, or perform everyday activities, a joint replacement consultation can help you understand your options.
Meeting with a surgeon does not mean you have decided to have surgery.
Our specialists can evaluate your joint, review treatments you have already tried, explain the potential benefits and risks of replacement, and help determine whether surgery is appropriate now or may become appropriate later.
Request an appointment with our joint replacement team in Sterling, Virginia.
