Therapies Advancing for Hip and Knee Challenges

Source: Lovin’ Life After 50: Tucson originally published on February 21, 2017

By Ali Dalal, MD

TUCSON – There are many welcome aspects of maturing – wisdom, experience, retirement and grandchildren, to name a few. Unfortunately, achy hips and knees aren’t likely to make the list. A lifetime of active living, sports injuries and even a surgery or two can result in joint pain caused by arthritis. This ailment can be one for mature populations.

The hip and knee joints are central to everyday movement, and when issues surface, many experience uncertainty and anxiety about treatment. Will I need surgery? Can I keep my lifestyle? What will my joint be like 10 years from now? 

Orthopaedic Surgeon Dr. Ali Dalal is a hip and knee specialist at Tucson Orthopaedic Institute. Dalal performs robotically assisted partial knee and total hip replacements using the Mako system. The surgery is planned with a 3D model of the joint and completed with the help of a robotic arm that does not allow deviations from the plan. Accurate implant placement may decrease complications and improve patient satisfaction.

He answers common questions about the treatment of hip and knee arthritis.

When should someone see a specialist? Standard aches and pains are common for people of any age, and they can increase in frequency as we add more candles to the birthday cake. So when does it become necessary to see an orthopaedic specialist?

If joint pain and lack of mobility are interfering with everyday life, one should seek the care of a specialist. I often see patients who are unable to rise after sitting on the ground with their grandkids or who have to take a break even after a short walk. It is important not to normalize constant joint pain as part of the aging process.

Is surgery the only option? Many who experience knee and hip pain are concerned that surgery is the only remedy.

Each person is unique, but a majority of patients do not require surgery. There are many effective therapies available, including physical therapy, oral anti-inflammatory medications, lifestyle modifications and joint injections. Many patients are surprised to find that the source of their pain was an easily treatable soft tissue injury that did not involve the joint at all.

When is surgery the best option?

If damage to the joint is severe and other therapies have not been effective, partial or total joint replacement can make a dramatically positive difference in a patient’s quality of life. Long-term studies have found hip and knee replacement to be some of the most durable and successful procedures ever invented.

Are technological advances making a difference?

There have been significant technological advancements in the last 15 years. Improvements in materials science have made joint replacements more durable, better understanding of pain management has reduced recovery times, and the advent of robotically assisted surgery has improved surgical accuracy, ultimately creating a much better outcome.

What are the outcomes?

Robotically assisted surgery has already been proven to improve accuracy in implant placement for partial knee replacement. The pitfalls in total hip replacement, specifically dislocation and unequal leg lengths, are driven by inaccurate component placement. Mako technology may help minimize these complications going forward.

Dr. Ali Dalal graduated Summa Cum Laude from UCLA with a Bachelor of Science in molecular cell and developmental biology. He earned his MD from the University of California San Diego and completed his residency in orthopaedic surgery at the University of Illinois Chicago. He completed a fellowship in hip and knee replacement at the Florida Orthopaedic Institute, where he worked with Dr. Kenneth Gustke, a pioneer in robotically assisted joint replacement surgery.