Frequently Asked Questions
Hip and knee replacement is a big decision.
We want you informed, confident, and comfortable before you ever walk through our door.
Surgery is a big decision. These are the questions every patient asks — and the honest answers you deserve before you decide.
New to Dr. Gough and not sure where to start? These answers cover the basics — who he is, where he practices, and what makes his approach different from other surgeons in the Scottsdale area.
Dr. Brandon Gough is a board-certified orthopaedic (bone and joint) surgeon based in Scottsdale, Arizona. He specializes exclusively in hip and knee replacement surgery and has performed more than 8,000 procedures since 2013. He uses advanced MAKOplasty® robotic-assisted, micro-invasive, and muscle-sparing hip and knee replacement techniques that most surgeons in the Scottsdale area do not offer.
Yes. Dr. Gough has volunteered with several charitable organizations: Magis Clinic (free medical care for underserved communities), Madonna School (supporting children with intellectual disabilities), Habitat for Humanity (building homes for families in need), and Sienna St. Francis Clinic (medical care within a homeless shelter). He believes that being a great physician means caring for the whole community.
Minimally invasive surgery uses smaller incisions --- typically 4 to 6 inches versus the traditional 10 to 12 inches --- and is designed to preserve the muscles and soft tissue surrounding the joint. This leads to less pain after surgery, a faster recovery, and fewer complications compared to traditional open surgical approaches.
A muscle-sparing hip or knee replacement approach means the major muscles around the joint are carefully worked around rather than cut. Because the muscles are not divided, patients typically experience significantly less post-operative pain, faster return to walking, and a more natural recovery.
Thinking about surgery but not sure what to expect before you get there? These answers walk you through everything from your first consultation to the day of your procedure — so there are no surprises.
You may be a candidate if hip or knee pain is significantly limiting your daily activities and non-surgical treatments --- such as physical therapy, anti-inflammatory medication, or injections --- are no longer providing adequate relief. Imaging showing significant joint damage is also a strong indicator. A consultation with Dr. Gough is the best way to determine whether you are a candidate and which procedure is right for you.
Most patients will try physical therapy, oral anti-inflammatory medications (such as NSAIDs), cortisone or hyaluronic acid injections, weight management, bracing, and activity modification before surgery is considered. Dr. Gough will review your treatment history and imaging during your consultation to determine whether surgery is the appropriate next step.
Dr. Gough will personally meet with you to review your medical history, discuss your symptoms, examine the affected joint, and review any existing imaging such as X-rays or MRI. He will explain your options in plain language, answer all of your questions, and work with you to build a treatment plan tailored to your goals and lifestyle.
Most patients will need standard X-rays of the affected joint. For procedures using the MAKOplasty® robotic system, a CT scan is also used to create a precise 3D digital model of your joint before surgery. This allows Dr. Gough to plan the procedure and select the right implant for your exact anatomy. Additional pre-operative blood work and cardiac clearance may also be required depending on your overall health.
Yes --- certain medications need to be paused before surgery, including blood thinners, some supplements (such as fish oil and vitamin E), and NSAIDs. Dr. Gough’s team will provide a full list of instructions specific to your medications during your pre-operative appointment.
Setting up your home before surgery can make recovery much easier. Recommended preparations include arranging a sleeping space on the ground floor if possible, removing area rugs and tripping hazards, placing frequently used items at waist height, having a shower chair or grab bars in the bathroom, and arranging for a caregiver or family member to assist during the first few days. Dr. Gough’s team will provide a detailed pre-operative checklist.
Yes. You will not be able to drive yourself home after surgery. Please arrange for a responsible adult to drive you home and assist you for at least the first 24 to 48 hours following your procedure.
Most joint replacement procedures are performed under general anesthesia. The type of anesthesia used will depend on your health, the procedure, and the anesthesiologist\'s recommendation. You will meet with the anesthesia team before your surgery to discuss the plan.
Yes. Patients who are in better overall health tend to recover more quickly. If possible, focus on maintaining a healthy weight to reduce stress on the joint and implant, completing any recommended pre-operative physical therapy to strengthen muscles around the joint, stopping smoking (smoking impairs healing and increases complication risk), and managing any chronic conditions such as diabetes with your primary care physician.
In many cases, hip and knee replacement surgery can be safely performed at an outpatient surgery center, also known as an ambulatory surgery center (ASC), rather than a traditional hospital. Advances in minimally invasive techniques, muscle-sparing hip and knee replacement approaches, and enhanced recovery protocols now allow many patients to return home the same day as their procedure. Dr. Gough performs both hip and knee replacement at Aloe Surgical Center in Scottsdale for appropriate candidates.
Hip pain is one of the most common reasons patients come to see Dr. Gough. These answers cover the most frequently asked questions about hip replacement — from what causes it to how long recovery takes.
Primary hip and knee replacement procedures typically take approximately 1 to 1.5 hours from incision to close. Revision hip and knee replacement is more complex --- those procedures generally take 1.5 to 3 hours depending on the case. You will be in a recovery area briefly after surgery, and most primary procedure patients are walking with assistance within a few hours. Dr. Gough will see you personally before and after the procedure.
Most of Dr. Gough’s patients manage post-surgical discomfort with Tylenol (acetaminophen) or Celebrex (celecoxib) --- not narcotic pain medication. The muscle-sparing hip and knee replacement techniques result in significantly less soft tissue trauma than traditional surgery, which translates directly to less post-operative pain.
Most patients use a walker for the first few days, then transition to a cane, and eventually walk without any assistive device within the first week or two. Because Dr. Gough’s technique preserves the surrounding muscles, this transition typically happens much sooner than with traditional surgery.
Primary hip and knee replacement patients typically go home the same day as surgery or within 24 hours. Revision hip and knee replacement patients generally stay 1 to 2 days for monitoring due to the greater complexity of the procedure.
Most patients can drive within 1 to 2 weeks after both hip and knee replacement, once they are off prescription pain medication and feel comfortable with the movement required. If surgery was on your right hip or knee, driving may take slightly longer as the right leg controls the brake and accelerator. Dr. Gough will provide specific clearance at your follow-up appointment.
Physical therapy for knee replacement patients typically begins within the first few days after surgery. For hip replacement patients, formal PT usually begins in the third or fourth week following surgery. Consistent physical therapy is the single most important factor in the quality and speed of your recovery.
For most primary hip replacement patients using Dr. Gough’s Direct Superior technique, there are no standard post-surgery hip precautions --- a major advantage over traditional techniques. For knee replacement patients, Dr. Gough recommends avoiding deep bending, twisting, running, or jumping until cleared. All patients should avoid driving while taking prescription pain medication and avoid swimming and hot tubs until fully cleared.
Contact Dr. Gough’s office immediately if you experience: increasing redness, warmth, or swelling around the incision; fever above 101°F; sudden increase in pain that was improving; drainage from the wound; calf pain or swelling (possible blood clot); or any feeling that the joint has shifted or dislocated. Call 911 for any signs of chest pain or difficulty breathing.
You will receive specific wound care instructions before discharge. In general, keep the incision clean and dry until fully healed, do not submerge it in water (no baths, swimming pools, or hot tubs) until cleared by Dr. Gough, and monitor for any signs of infection. Dr. Gough’s team will schedule a follow-up appointment to check the wound and your recovery progress.
Yes. Dr. Gough schedules follow-up appointments at regular intervals after surgery to monitor healing, assess your function and range of motion, review imaging as needed, and adjust your recovery plan. Regular follow-up is important for long-term implant success. Even after full recovery, periodic check-ins are recommended.
Return-to-work timelines depend on the type of work you do and your procedure. Most patients with desk or sedentary jobs return within 1 to 2 weeks following primary hip or knee replacement. Those with more physically demanding jobs may need 6 to 12 weeks or longer. Revision surgery patients typically require additional recovery time before returning to work. Dr. Gough will provide guidance specific to your procedure, job requirements, and recovery progress.
Most patients return to activities they love --- including golf, hiking, cycling, swimming, and walking --- within 4 to 12 weeks depending on the procedure. Dr. Gough’s muscle-sparing hip and knee replacement and MAKOplasty® robotic techniques are specifically designed to support an active lifestyle long-term. High-impact activities such as running or jumping sports may require additional discussion with Dr. Gough.
Whether you're dealing with arthritis, an old injury, or pain that just keeps getting worse, these answers cover the key things patients want to know before exploring knee replacement as an option.
MAKOplasty® is a robotic-assisted surgical system by Stryker that allows for a level of precision not possible with traditional surgery. Before every procedure, a CT scan creates a precise 3D digital model of the patient's knee. Dr. Gough uses this model to plan the surgery, select the right implant, and prepare every step before making a single incision. During surgery, the Mako robotic arm guides each movement with precision — removing only what needs to be removed and placing the implant exactly where it belongs.
Yes, for most patients. Dr. Gough's partial and total knee replacement patients are typically discharged the same day as surgery or within 24 hours. Revision knee replacement patients generally stay 1 to 2 nights for monitoring due to the greater complexity of the procedure.
Recovery looks very different with Dr. Gough's approach than with traditional surgery. These answers cover what to expect after your procedure — pain levels, walking, driving, physical therapy, and returning to the activities you love.
Most of Dr. Gough's patients manage post-surgical discomfort with Tylenol (acetaminophen) or Celebrex (celecoxib) — not narcotic pain medication. The muscle-sparing and minimally invasive techniques result in significantly less soft tissue trauma than traditional surgery. Dr. Gough's team will provide a clear pain management plan before your surgery during your pre-operative appointment.
Cost and coverage are real concerns — and you deserve straight answers before you commit to anything. These answers explain what most insurance plans cover, which plans Dr. Gough accepts, and how his team can help you verify your benefits before your consultation.
Most major insurance plans cover hip and knee replacement surgery when it is medically necessary. This typically means the patient has tried non-surgical treatments without adequate relief and imaging confirms significant joint damage. Dr. Gough’s team will help you verify your coverage before your consultation.
Gough Surgical accepts most major insurance plans, including United Healthcare, Cigna, Aetna, Blue Cross/Blue Shield, Ambetter, and Medicare. Please contact the office at 602-359-3088 to confirm whether your specific plan is in-network and to discuss your coverage details.
Yes. Medicare generally covers hip and knee replacement surgery when it is medically necessary. Coverage specifics depend on your plan type (Original Medicare vs. Medicare Advantage). Our team will help you understand your benefits and any out-of-pocket costs before your procedure.
Out-of-pocket costs vary depending on your insurance plan and deductible. Typical costs may include your deductible, co-insurance after the deductible is met, and any costs for services not covered by your plan. Our team will review your specific coverage and give you as clear a picture as possible before you make any decisions.
Simply call our office at 602-359-3088 or provide your insurance information when completing the appointment request form online. Our team will contact your insurer to verify your benefits, obtain authorization if required, and let you know what to expect financially before your consultation.
Curious about how the MAKOplasty® robotic system actually works — or whether the robot is doing the surgery? These answers explain the technology in plain language so you know exactly what to expect.
Dr. Gough uses the MAKOplasty® robotic-assisted surgical system (by Stryker) for both hip and knee procedures. This technology allows for a level of precision, customization, and surgical accuracy that is not possible with traditional manual techniques.
Before surgery, a CT scan of the patient's joint is used to create a precise 3D digital model. Dr. Gough uses this model to plan every aspect of the surgery --- the exact implant position, the amount of bone to be removed, and how the new joint will move with the patient's specific anatomy. During surgery, the Mako robotic arm provides real-time guidance to ensure every cut is precise and every placement is accurate.
No. The Mako robotic arm is a tool that Dr. Gough controls and guides during surgery. The robot assists with precision and real-time feedback, but the surgeon makes all decisions and performs the procedure. Think of it as power steering in a car—the surgeon is always in control.
MAKOplasty® robotic-assisted surgery offers several key advantages: personalized pre-surgical planning based on your exact anatomy, highly accurate implant placement (one of the strongest predictors of long-term implant success), less removal of healthy bone and tissue, smaller incisions, faster recovery, reduced need for pain medication, and consistently better long-term outcomes compared to traditional manual techniques.
Yes. For hip procedures, Dr. Gough uses MAKOplasty® robotic-assisted technology combined with 3D CT-based digital planning to design a custom surgical approach and select the optimal implant before surgery. His specialized Direct Superior technique combines MAKOplasty® robotic precision with his extensive experience in minimally invasive hip reconstruction.
In most cases, insurance covers the procedure itself regardless of whether robotic assistance is used, as long as the procedure is medically necessary. The MAKOplasty® robotic technology is part of Dr. Gough’s surgical approach, not a separately billed service in most cases. Our team will clarify coverage specifics for your individual plan.