AHF Podcast
AHF Podcast
Rewriting Patient Recovery (Interview with Andrew Wickline, MD)
Revolutionizing Patient Recovery: Dr. Andrew Wickline's Mission for Opioid-Free Healing
In this episode of the AHF Podcast, host Joe Schwab interviews Dr. Andrew Wickline, an orthopedic surgeon, educator, and author committed to improving patient recovery and education. Dr. Wickline discusses his books 'Less Swelling, Less Pain' for total hip and knee replacements, the importance of patient engagement, and his groundbreaking '1 Million Patient Mission' to eliminate opioid addiction risks. The conversation covers the current landscape of patient recovery education, the benefits of the anterior approach, and future innovations in surgery and recovery.
Hello, and welcome to the AHF Podcast. I'm your host, Joe Schwab. Dr. Andrew Wickline is an orthopedic surgeon, educator, and author of two books, less Swelling, less Pain, total Hip. And less swelling, less pain, total knee. Both books are now available in Spanish reflecting his deep commitment to accessible patient care and education. Dr. Wickline, thank you for joining us.
Andrew Wickline:Good morning from upstate New York. Glad to be here.
Joseph M Schwab:Um, let's start with your book. Uh, less pain, less, uh, excuse me, less Swelling, less Pain. What inspired you to write these and what's really your goal in making them available to a wider audience, including Spanish speaking patients? I.
Andrew Wickline:Well, uh, back in 2015, I heard, uh. Dr. Craig McAllister and Dr. Ira Kirschenbaum, they, they talked about how, um, patient engagement was the key towards allowing patients to go home the same day. And, uh, so they convinced me to kind of write my, my version of the book and took me six months. I mean, most surgeons were busy. They've got a bunch of flyers they hand out at at different time points postoperatively. But I sat down, I said, what if I was a patient? What. What would that book look like? You know, when your daughter, uh, or wife gets pregnant for the first time, she gets this book called What to Expect When You're Expecting. Right. Everybody in the United States has seen that. Um, and then, you know, if you have a family member, uh, like with my wife, when she had cancer, we had this amazing book to Breast Cancer handbook, you know, how to, how to Succeed and get through this really terrible time. And I recognized that Total Knee and Total Hip, it's not a lot of fun and it's a, it's a big black box for patients so. I, I wrote the, the first book, I've, I've revised it 31 times and since that time of the very first book, we've published lowest opioid use in the United States. We, uh, just published lowest swelling worldwide after knee replacement. And so I thought it was time to, to bring the, uh, that, that data, those publications all in one book to patients, uh, direct to patients.
Joseph M Schwab:So what have you seen or, or in your research, what is the landscape for current, you know, patient recovery education look like?
Andrew Wickline:So it's kinda all over, uh, the, the, uh, field. It's, you know, I, I've, I've operated with many, many different surgeons, uh, over 60 surgeons. Uh, and, uh, and it's, you know, when you're busy, when you're not busy, you, you have time to do all these things, but once you get busy, it's really challenging the way, um, uh, most surgeons do it. They've got their handouts again, just like what I was doing, but it, it's. It's very hit or miss and it's very sporadic. I really think we could do a better job at tightening up the protocol. Um, you know, otherwise patients go to Dr. Google and that's, that's a terrifying experience. You know, I, I've got 8,200 hours of my life, you know, that's four full-time years of working, uh, nights and weekends away from my, my wife and kids, you know, and I, and I tell patients, listen, this is my love letter to you. I took time away from my family to help you succeed. And so. They would take the book, they would journal in it. I've got 7,000 patients that have given me the book back, and I, I, I'm able to see really amazing detailed descriptions about what happens every day post-op, what to expect. It's not just black and white, a pain score, a three or a four. It's, you know, actual sentences. Hey Doc, I really have trouble rolling over at night. You know, what, what, what is that? Normal? And, and patients are worried. They wanna know what's normal, what's not. And it answers every question the last 23 years of practice. You know, can I have a flu shot? Uh, what are the parts made of, uh, what's the best diet? Uh, am I ready for surgery? I got two whole pages to help patients determine, am I ready for surgery?
Joseph M Schwab:Is it, so you mentioned Dr. Google. Is that how you find most patients are currently learning about recovery? Apart from, of course, the. The patients that you're given your book to.
Andrew Wickline:It seems like it, you know, uh, when you look online, look at the blogs, there's lots of, you know, um, uh, patient organized blogs to, uh, to kind of help people because, because their doctor isn't doing it, you know, isn't providing the information, and so they feel the need to do it themselves. So I. Um, this is one way that, that you can have qualified information if you, if patients look in my book, I, I've got, uh, references to each of the articles that are published that help, uh, show them where they can find, actually find the science behind the recommendation I'm giving them.
Joseph M Schwab:Yeah. And do you find, does your book also sort of create or recreate that sense of maybe community that some folks feel online with an online blog?
Andrew Wickline:I think so because there's actual patient quotes every single day post-op. So the book is kind of divided in two, two parts, you know? Um. What to expect before surgery. How to optimize each of the different body systems, you know, if you're a man, if you have prostate issues, did you know that, you know, certain types of anesthesia can put you at more risk for having, uh, you know, prostate, you know, problems post-op and wearing a catheter. Nobody wants that and nobody's gonna be happy with that, with that outcome. So at least if you can discuss it with patients, that helps, you know, post-op, uh, uh, you know, I generally have a, a, a good comment and a and a. And a patient who's got having a rough day comment to kinda show that range, uh, so that, um, patients can say to themselves, well, I guess this is normal. I, you know, I thought I was worried when I woke up this morning with this new problem. Uh, and um, but geez, there's four quotes in the book that said this is normal.
Joseph M Schwab:Of course, patients have access. All, All patients everywhere would have access to your book, right? It's available, you know, for them to purchase. But for a, a number of patients who are seeing their doctor are getting their, uh, information directly from their doctor. Um, what concerns you most about kind of the current approach that surgeons are taking towards educating their patients about their recovery?
Andrew Wickline:Well, you know what's been really helpful is I've had several surgeons, hips and, you know, surgeons who've had hips and knees who've actually got, purchased my books and, uh, reached out to me and said, wow, I did not realize this or that, or this or that. And that's the surgeon themselves, right? Who's, who's been doing this for 5,000, 10,000, 20,000 cases. And, um, it's, it's really hard to put yourself in those shoes until you've. Until you've walked it. Right. I, I've had patients stay at my house, uh, because of covid and a few, uh, challenging, uh, situations. And, um, you really start to learn a lot more about what recovery's like when you actually go and visit the therapist and watch the patients, uh, being tortured after surgery. Uh, because our industry has told patients to go, go, go. And, uh, and I think that's a mistake. We, we certainly don't do that. If you sprain your ankle, you wouldn't. Walk, you know, 10,000 steps the night after Spraining your ankle. We've all learned that lesson as a teenager. So I think part of it is just we, we really, um, we all go to these meetings. We focus on the one hour of surgery at the meetings, but, but there's six weeks pre-op, 12 weeks post-op, that's 3000, 24 hours that we could be focusing on, and yet we only focus on one.
Joseph M Schwab:Yeah, and it's interesting'cause a lot of the publications about outcomes for total hip, total knee, you know, they'll want two year outcomes and a lot happens in that first two years. What's the incentive for the surgeon to focus on that recovery in the first three months if really, you know, most of the literature is on two year outcomes.
Andrew Wickline:So you are right, and it's just easy to tell patients. Well, it'll all be better in, you know, uh, at a year or two years and, you know, hang in there. But I. But again, if you have something that's actually documented, that's published that, that has data behind it, that, that with publications, at least the patient, if that's the, the case, which again, there is healing out to two years, nine, it takes 92 years to get 98% healing of the wound. Um, you know, at least the patient can see it. And, and it. It, it feels more like it's the truth, right? When we tell, if a patient says, doc, I'm still sore at three months, and the doc says, well, that's normal, and, and it'll all get better by a year. It kind of feels like we're brushing them off. But yeah, they can see in the book that it says, you know, here's. You know, you only have 50% healing at week six. You know, at three months you're gonna have 15% more water in your leg than normal still. Um, okay, well that is, that's a reason why I'm still sore and it's okay. This, it, it's not an infection. I'm not rejecting the implant. People think they reject implants, so, you know, again, the mind goes to the darkest place. Um, that's, that's what happens when we encounter something that, that no one gave us an explanation for before.
Joseph M Schwab:Is there anything we should be doing in the literature to change the incentive structure for patients? Or excuse me, for, for surgeons to be making, uh, patient recovery education a higher priority?
Andrew Wickline:Um, well, I can say that, that, so to incentivize, I don't think the literature is going to push unless, unless you can, you know, I. Do this large multicenter study with a specific protocol and follow these patients for two years. I mean, I guess that's one way to do it in the literature, but. Boy, that's gonna be a challenge to get done. And who's gonna pay for that? You know, uh, I think really what needs to happen is, uh, the, the government needs to incentivize surgeons to do this, right? Um, you know, we've published lowest opioid, lowest swelling, uh, uh, and with that comes, uh, you know, over a 50% reduction in 90 day recidivism rate, you know, coming back to the hospital. So lower complications using this protocol. And so. You know, I think if we can incentivize, if the government says, you know, let's incentivize surgeons to, to reduce opioid prescribing and reduce complications, that's the way to do it. I, I, I, I guarantee if the government came out tomorrow and said, we're gonna pay surgeons an extra thousand dollars, uh, for lower opioids, lower complications, and, and there's no, um. Uh, and there's no downside to it. Like they did that for B-P-C-I-A, right? The, the, the government plan. But, but boy, that was Russian roulette. Like many people got burned because, you know, got a readmission, um, because they didn't have the right protocol. How about we just incentivize people to, to uh, do the right thing And, uh, and, and if, if you win, you get to share in the savings. And if not, you're trying hard to win. I think we just need to refocus on this.
Joseph M Schwab:So, shifting gears a little bit, one thing that really stands out about your career, um, uh, just looking over it, is your dedication to learning from others. And you've, um, I I read that you've either visited or hosted over 60 surgeons over the last 20 years, which is a truly remarkable number. Uh, and I'm curious to know from your perspective, what inspired this, uh, interest in an exchange of ideas.
Andrew Wickline:Well, I think it's a couple things. Um. First, you know, as a resident, we don't, we don't learn by just going to a, you know, a, a two hour lecture or, or a two two day weekend le series of lectures. We, we operate with multiple different surgeons and we we're, we're watching different artisans and learning from their craft, right? And so that's how to do the procedure. But then, you know, um. The real key is going to the office and actually seeing those patient outcomes more than a, a binary, you know, a, you know, zero one or a, or a pain score or a, um, a prom score that, that's not as really helpful as actually seeing the patients that, that are in each of these surgeon's office. So I think, I think that's. I mean, that's how we learn and, you know, as residents. So why aren't we doing that when we, when we leave fellowship? And the number two reason is I'm from West Virginia. Uh, I didn't have a lot of money growing up. I was always told I was second best. And, um, you know, some people they knuckle under that pressure. They, you know, I was told I wasn't ever gonna be able to be a surgeon. Um, let, let alone, um, you know, uh, successful. And so some people will knuckle under and I, I just made me mad so. I, um, I said, no, I'm gonna prove to people. So that was very helpful in some ways, but it's, it's a monkey on your back, right? I, and, and so I. At Aus, unfortunately, that we see this still. I, I stood up in 2013 and I said, you know, I think we're hurting patients with therapy. I live in a small town. I'm seeing patients really suffering. I think we should stop therapy. And the whole, the whole room laughed and you know, you know, because when I said we should stop there, and I, I persisted. I said, no, I, I'm in a small town. I'm, I'm, I was one of the busiest striker users in New England at the time. And, uh, I, I do a lot of work and, and a guy in the lectern actually said, no, we're serious. Shut up. Sit down if you believe that nonsense. Come back when you have something published. And that was mortifying to me. And you know, again, kinda my whole life, I've been told I'm second best now here I am with all my computers. You're second best. So, so I, I, in hindsight, I want to thank that gentleman, uh, because he spurred me to start looking at my outcomes and start looking at more than just the surgery. I. But also all the other steps that six weeks before 12 weeks, that other 3000 plus hours that we could be optimizing, that's low hanging fruit, man. That that's really the, that's when the patient's awake, by the way, when you know those other 3000 hours. So you better be paying attention to that.
Joseph M Schwab:Uh, my goodness. So that, that sounds like it was a really, um, a challenging experience at that, at, at the, the meeting. Were, were there other experiences that come to your mind that really challenged the way you, uh, were thinking or the way that you, you know, that transformed your approach to your patients?
Andrew Wickline:You know, um, there's a lot of surgeons that have, you know, been, been helpful. Uh, you know, at that meeting, the only person who stood up for me at that meeting was Adolf Lombardi. I mean, that, that, that man's a real gentleman. Uh, you know, he said, you know, Andy's been to my place twice and, uh, I think, I think he, he might be onto something. And then over the years, you know, Frederick Load, uh, from Paris, I mean, just an amazing anterior hip surgeon. Uh, and he's been doing a lot of, uh, videos recently on LinkedIn, you know, showing and highlighting. Some of the things he's learned. Um, uh, of course Joel Mata. Um, he and I have shared love of airplanes, so, uh, I, I get to speak to Joel every so often. Nick Mast, uh, um, Charlie to cook. There's a whole bunch of surgeons that have, have showed me their little tricks and pearls and, uh. I've been very fortunate and I, I, I would encourage all surgeons to spend time. I just had a surgeon, uh, Jim Mitchell out from, uh, Oklahoma the last two days. It's super helpful to have someone come to your place and, you know, help poke holes in your thinking to say, Hey, why are you doing it that way? Is, is there, would this work, uh, a little bit better? It's very, very, um, the collaborative nature of this is, has been really exciting.
Joseph M Schwab:So you kind of touched on a, a number of folks who are in our sphere, in the anterior approach sphere with Dr. Matta and Dr. De Cook and, and Nick Mast and things like that. When did you start doing anterior approach? And I know one of. Your concerns is about pain management and opioid use. Did you see any differences in opioid needs between patients that you were doing anterior approach on and patients having other approaches?
Andrew Wickline:Yeah. So, um, you know, I, I, I have a, a, a. My residency was almost entirely, um, uh, posterior. I did a little direct lateral, um, at the time, and, uh, um, I. We had a surgeon, uh, that was there, he was working on the two incision hip stuff. So then I went and did my fellowship and, uh, that was all direct lateral with Leicester Borden and, uh, Cleveland Clinic. And so I've got five years of practice, uh, uh, using direct lateral with good results. But, you know, the, the limping, the, you know, the, the early recovery was a challenge, you know, no, it didn't have that dislocation risk with the posterior. And so then we did some two incision stuff, uh, and then, um. You know, the literature was coming out kind of against it in some ways, in some centers, so it was challenging to continue. So that's when I fell into, uh, direct interior. We did a bunch of courses. I started in 2007. I started without a table. Like I, I, uh, moved over to using a table. I found that much more reproducible, uh, and. When, when we really started doing it, uh, for real, I didn't, you know, none of my office staff knew the difference. My x-ray tech came to me and said, uh, Andrew, um. You know, this is the time we had non-digital x-ray. Right. Andrew, what are you doing different? Um, the patients can get on and off this supine, you know, x-ray table so much easier. So is is there something different you're doing? And then, uh, that's when I knew that I really had a game changer. Um, and so yeah, it was, that was kind of the telling point for me in my office that this was definitely something different.
Joseph M Schwab:Um, as far as pain control is concerned, did you notice any differences in patients or was it mostly functional recovery?
Andrew Wickline:Uh, no, it was definitely both. Uh, it's just the, the need for, for opioids, uh, was definitely lower. Um, and, you know, we, we. Ultimately, I had a physical therapist. She, she thought she was gonna prove me wrong. You know, the patients don't need therapy. And so she wrote a paper with me and we actually saw about 90% of patients use 10 pills or less. Uh, mostly tramadol. And now with a few more tweaks with my protocol, I we're, we're gonna have to do another study.'cause I think we're at 80 to 90% using zero opioids now.
Joseph M Schwab:Wow. Wow. Um, le let's talk a little bit about, you have, uh, something called the 1 million Patient Mission, um, which is, I would say inspiring and pretty bold. Um, the goal seems to be to help 1 million patients have zero opioid addiction risk after total hip and total knee replacements. What I'm curious is, from your perspective. How'd you come up with this mission, and specifically, how'd you come up with the number? A million is bold.
Andrew Wickline:So. The Baron Brothers again, I'm so lucky that many surgeons are willing to put up with me in their, or. The Baron Brothers invited me out to their, their meeting, uh, a couple years ago, and that's, uh, happens, uh, that they brought in, uh, or, uh, Mor Malu. I know, or I'm sorry if I'm saying your name wrong, he's the PhD, uh, that's works at Harris Hip Labs. He's responsible for, um, cross-link polyethylene and, uh, when, when they started looking at numbers. That guy has helped over 20 million people have a longer hip and knee replacements. And I, I, for, for the last couple years, I'm like, man, I, I wish I had that kind of influence. I have a very small sphere of influence, right? My little town, you know, maybe a few people that you see our podcast and so forth, and use our books, but, you know, it's, it's not 20 million. So I've been looking at my, I got 10 years left, uh, before I retire. I think, uh, depending on how this stock market goes. my kids decide to continue doing. But, um, so I said, okay, there's about 1.6, uh, 1.7 million total joints a year. If I could affect a hundred thousand a year, that'd be like 7% of the market. Um, I. You know, in 10 years when I retire, I, I could help a million people. So I said, you know, that, I think I like this. This let's march to a million. Uh, and that's March the number two a million.com. We have a website where, where patients can go on and, and surgeons can get my free DPDF. And if your patient doesn't 10 pills or less, I want them to go to that. Website, log in with their first name tag their surgeon claim their, their own personal number on the internet wall of fame, that they did it in 10 pills or less. And we have a leaderboard where, where we're gonna find out which surgeons and which, uh, you know, cities and states are winning, uh, in this, this problem. I mean. In 2018, I published and presented 10 pills or less for total knee, like unheard of. In 2020, we actually published those papers and then Covid hit and the whole national conversation left this opioid epidemic problem and we've gotta fix this. I, one in four of my patients talked to me about personal family members. Or, or a friends that, that they've lost because of opioids. And I, I'm mad, you know, I thi this is fixable and so I've got a bunch of surgeons already signed onto this. We're going to, we're gonna change, uh, the national conversation. We're gonna get it back to where it belongs, and we're going to encourage all of other surgeons who aren't doing these things to, to improve pain perioperatively to get on board. Yeah. I think this should, this operation should be 10 pills or less.
Joseph M Schwab:So we'll put a link to the March to a million in our description, certainly with the podcast. But I wanna know, uh, maybe you can give us a sneak peek. What progress have you made so far?
Andrew Wickline:So again, I've, I've got 30 plus surgeons who, you know, they, they bought in, it's easy to buy in, right? It's, it's essentially, you know, advertising their practice that, that they care enough, uh, to, to uh, uh, provide education, provide, uh, um. techniques and. Uh, allow patients to recover, uh, with a, with way less if zero, uh, risk of opioid addiction. And so, you know, like that's, that's super hard to, to get surgeons together, right? We, we all feel we're number one, we're all great white sharks in our little area of the ocean. And so we have to find ways that we can collaborate. And I think this is a great way, it's, it's a competition. Uh, we're also doing a video documentary of this, uh. So, yes, the, the I I I, I'm flying my little plane. I pull it outta the hangar and I, uh, uh, I just picked up, uh, John Balk out of Cleveland to come out and visit with us. Uh, I flew down to see John Mercury. Uh, um, I'm flying down this, uh, coming week to see, uh, Del Shoote, uh, to, to give a lecture down there. So, uh, pulling out my little march to a million plane, uh, with the big jets behind. It's the story of my life, David versus Goliath. I am gonna fix this problem. Uh, I do not want these things on the.
Joseph M Schwab:So, I mean, this is a huge lift that you're taking, and obviously it sounds like for a good cause the many of the surgeons who are signing up, they're making a pledge to do things differently. But if there was one small change a surgeon or a care team could make today that would create, um, from your perspective, a huge impact in recovery or outcomes for their patients, what would that be?
Andrew Wickline:Uh, so I agree, starting small is the key. Uh, um, any of the surgeons listening that can reach out to me, I've got, you know, 40 plus ways to help reduce swelling. You know, again, part of it's in the book, but, you know, you don't have to use my book to do this. Um, the first thing I would say is, uh, let's look at the step count man Dome Karina Outta Florida. Neither of us knew we were doing this research, but both of us came up with the same step count post-op, uh, to help patients recover, right? Again, we talked about this earlier. If you sprain your ankle badly, you don't try to do 10,000 steps the next day, but yet for knees and hips, we tell patients to go, go, go. But, but that's not what we tell patients for a rotator cuff or having a hernia repair or any other surgery. So we have to understand that the, the, the wound is more than just the bone that we pounded parts into. Uh, we've got to help that wound, uh, uh, heal better. And that's by controlling that swelling. There's. There's a lot of great stuff we're gonna be working on the near term. Um, and, uh, but, but I think number one key is start with the step count. Number two, recognize that swelling is a real thing. I mean, 34% more water on the leg on day seven, uh, not day one or two, but day seven a week later, it's only 2% less, so 32% more one on a leg. We have to manage that, and until we recognize that those are real parts, then you're not gonna see the success.
Joseph M Schwab:Do you have a message for surgeons who currently feel stuck in sort of the traditional models of care?
Andrew Wickline:So. Yeah, I guess, uh, I'm, I'm happy to either come visit you or you can come visit me. Um, we, you know, the very first person that came to visit was a surgeon out of, uh, uh, LA and um, uh, this was back in 2018 after he heard the talk and I we're driving to my clinic and he says, I said, why, why did you come all the way to, you know, Utica, New York? And he goes, because I call BS on your results. There's no way you're doing this in 10 pills or less. And, um, and, uh, after four hours in clinic, he goes, okay, uh, I believe you now, and I'm gonna make these changes. And it, there's just, it's just some simple changes and you don't have to do it all at once. You know, start with some simple things, you know, it's a six month process. I've, I've got a kind of roadmap for patients, uh, and for surgeons as well, um, to, to help succeed. Again, if you try to do it all at once, it is overwhelming. Agreed.
Joseph M Schwab:When you have the opportunity to look back on your legacy, um, through your books, through your patient care, through the, this, the the million patient mission and your global collaborations, um, what do you want it to look like?
Andrew Wickline:I guess I just wanna know that, that I did more, I mean, it's important to help our people in our local town, but at some point I. Those of us who've been doing this a long time, it's time to give back to the younger surgeon that is still struggling on trying to understand what, you know, again, how does a 30 5-year-old surgeon understand what it's like to have a knee replacement? Really, you know, uh, unless they have one themselves or they go and, and live with that person, uh, for the next six weeks. So, um, I think it's. It's incumbent upon, uh, older surgeons to just, you know, share the wisdom that we have and, you know, the dos and the don'ts and, uh, but again, to keep trying to push forward. Um, I'm excited for what the future holds. I, I don't know. I, I, my, my belief is that in the next 15 to 20 years, we may not be putting metal in, plastic in, I think we'll be replicating cartilage 3D printing with nanobots. Um, but the key will still be understanding the. The, the cytokine milieu in that knee and understanding the basement membrane adhesion, uh, and uh, uh, trying to mitigate those shear forces to allow that healing to occur. So I'm excited. I hope I get to see that. Um, but I think it's coming.
Joseph M Schwab:What, so you, you talked briefly about what you think, uh, the surgery will look like in, in 20, 30, 50 years. What do you think the recovery's gonna look like in 50 years?
Andrew Wickline:That's hard. It's hard for me to know. I, I. Um, you know, we have our cells are, you know, we're over 50. Our cells are, they call'em senescent, which is, is a terrible word, but That's true, you know, and, um, and so these cells act as, uh, pericrine cells. So they, they control the surrounding milieu in near, in the regions of trauma. So the next five years, I'd like to see, um. I'm trying to work with some of our, uh, um, basic science, uh, members, uh, inflammation, uh, specialists, as well as gate specialists. I'd love to sit down and work with them on another kind of landmark paper looking at how do these senescent cells, instead of going down that fibrotic pathway, how do we get them to go back to that? That reparative pathway. And I think by understanding that that's gonna help us, uh, as uh, the technology allows us to do things with cartilage surfaces, I think we, we need to have that together. We can't, we can't have one without the other. So, um, I'm excited that the short term, I think we can help recovery, uh, by looking at the, how the soft tissue reacts to the trauma. And in the long term, uh, I don't know. I'm, I'm, I still hit things with a hammer, so it may be.
Joseph M Schwab:Uh, well, I can't think of a better place to end than that, but Dr. Wickline, I I really appreciate the time that you've taken with us today, and I look forward to hearing your full talk at the AHF uh, 2025 annual meeting.
Andrew Wickline:Thank you so much for having me and uh, really, uh, I really appreciate the opportunity.
Joseph M Schwab:Absolutely. you for joining me for this episode of the AHF podcast. We think of the AHF as a family, so if you can remember to take a moment to like and subscribe, you'd be helping us find more people just like you to share our thoughts with. And as an AHF family member, you can always drop an idea for a topic or any feedback you like. In the comments below, you can find us on Apple Podcasts, Spotify, or in any of your favorite podcast apps, as well as in video form on YouTube slash at anterior hip Foundation, all one word. New episodes of the ahf Podcast come out on Fridays. I'm your host, Joe Schwab, asking you to keep those hips happy, healthy, and swelling free.
