Premier/Crozer-Keystone Physician Spotlight: Eugene Elia, M.D. 

Eugene Elia, M.D., is an orthopedic surgeon at Delaware County Memorial Hospital. He received his medical degree from Temple University School of Medicine in Philadelphia, completed his residency at Albert Einstein College of Medicine in Philadelphia, and his fellowship at the Hospital of the University of Pennsylvania.

Dr. Elia routinely gives community-based presentations and enjoys being able to educate and provide this service to the public. The following information is based on a presentation he gave about how to relieve hip and knee pain—from medication to exercise, rehabilitation and surgery.

 “The reason you get arthritis is that you literally take a lot of steps during the course of your life,” Dr. Elia says. “By the time you reach age 75, you would have circled the globe four times. It’s an amazing amount of distance. Each year, you actually move your hips and knees back and forth between one and two million times. That’s why you need to take care of your joints.”

The hip joint, Dr. Elia explains, is a “ball-and-socket” joint. This joint allows the hip to move in three directions, and makes it one of the few areas in the body where rotation occurs. The knee, on the other hand, acts more like a hinge, with a back-and-forth motion.

In both the hip and the knee, the area between the joints is cushioned by a substance called cartilage, which keeps the bones of the joint from rubbing together. For many people, the constant movement of the hip and knee joints results in the wearing away of cartilage, which allows one bone to rub on another and can cause significant pain.

“Cartilage continually wears away over the course of your life, starting at age 1,” Dr. Elia says. “It doesn’t become symptomatic until usually about age 50, unless you’ve experienced trauma from a car accident or fall, for example. When it becomes symptomatic and starts to hurt, you’ll usually go to the doctor, who will diagnose you with osteoarthritis.”

In general, the onset of osteoarthritis can be staved off for a few years through a combination of several different techniques.

“We recommend a program called SAVE, which stands for situating your environment, avoiding further wear and tear on your joints, varying your positions frequently, and exercising faithfully,” Dr. Elia says.

In order to situate your environment, Dr. Elia recommends checking your house for safety hazards and items that could contribute to cartilage degradation. 

“Living on one floor is best,” he says. “If you have the money to add a bathroom, put some rails in, or install a chair lift, do it. Also, you can do some common sense things, such as putting in higher-wattage light bulbs, getting rid of scattered throw rugs and moving clunky furniture that gets in your way.”

To avoid further wear and tear on your hip and knee joints, try to do your normal activities from a standing or seated position.

“If you have a dishwasher, stack everything on the top so you don’t have to bend over,” Dr. Elia says. “When you cook, use the top shelf in the oven, and keep your pots and pans in a cabinet with sliding shelves. Don’t kneel down to scrub the floors—use a mop or a vacuum. And use a little stool when you’re out gardening to avoid spending too much time on your knees.”

Using crutches or a cane, even on a temporary basis, can also help avoid wear and tear on the hip and knee joints.

“Don’t be embarrassed to use a cane or crutches,” Dr. Elia says. “They can keep you independent and would definitely take a lot of stress off your joints.”

Dr. Elia also recommends varying your positions frequently. “Keep your joints moving,” he says. “Stiffness can creep in after about an hour. When you are sitting, move your knees around, avoid keeping them straight. Sit with your knees and hips in a relaxed position and keep them bent a little bit. Cross your knees and switch your legs back and forth, unless you’ve had a hip replacement. And when you are laying down, use a pillow between your knees, especially if you have difficulty laying on your side.”

Finally, Dr. Elia recommends daily exercise to ward off painful arthritic flare-ups.

“Again, exercising prevents stiffness,” he says. “Also, by exercising, you can strengthen the muscles around your joints, which helps support the joints and reduces the rate of wear and tear on the cartilage.”

If you are diagnosed with severe osteoarthritis, you have few options.

“Nine times out of 10, your doctor is going to suggest the inevitable, which is surgery,” Dr. Elia says. “In the past, artificial joints were made of metal, and the scars left by replacement surgery were about 12 inches long. Today, with new technology and new instruments, we are able to put artificial joints in through an incision between 3 and 4 inches, which results in less pain and less recovery time. In addition, the joint surfaces are made of ceramic, metal or plastic, which gives the joint a nice frictionless type of motion, similar to the natural movement of the body.”

Post-surgery, pain usually subsides after just a few days, and most patients are able to walk after 2 or 3 days. Your physician will probably restrict certain positions and movements, such as sitting with your legs crossed or kneeling for extended periods of time, but you will be able to resume most normal activities within a few weeks.

“You will eventually be able to walk as far as you want after hip or knee replacement surgery,” Dr. Elia says. “Swimming and biking are wonderful ways of exercising. Golfing and dancing are no problem. Of course, certain activities are out. Jumping and running are restricted, as is playing singles tennis. Doubles tennis is fine, though.”

In addition to surgery, pain relief options include medication and injections, such as cortisone, and activity modification.

In order to find out which option is best for you, Dr. Elia recommends speaking with your primary care physician. He or she may recommend a consultation with an orthopedic surgeon or rheumatologist to explore your symptoms and treatment options.

Eugene Elia, M.D. is on the medical staff of Delaware County Memorial Hospital. He has an office location in Havertown. For appointments or referrals, please call (610) 449-6499.