Physician Spotlight: Eugene Elia, M.D.
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
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
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
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.”
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.”
or a cane, even on a temporary basis, can also help avoid wear and tear on the
hip and knee joints.
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.”
Elia recommends daily exercise to ward off painful arthritic flare-ups.
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.”
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
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
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.