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In this episode of the AHF Podcast, host Joe Schwab interviews Dr. John Horberg. They first met in the fall of 2024 during the Revision Round Table series, where John's complex cases from rural Wyoming impressed Joe. John discusses his journey from Southern Illinois to building a successful total joint practice with Premier Bone & Joint Centers in Laramie, Wyoming. They talk about the logistics of running a practice with twelve locations and a fleet of planes to reach patients across the state, the value of preparation, and the complexity of handling revisions from an anterior approach. John also shares insights on building a supportive team, succession planning, and the challenges and rewards of practicing in a rural setting.