Robert J. Avino, M.D. — Palm Beach County
When Hip or Knee Arthritis Leads to Joint Replacement
For many patients, hip or knee arthritis eventually reaches a point where non-surgical treatments are no longer enough. Understanding when that threshold has been reached — and what options are available — is the first step toward making an informed decision.
Dr. Avino evaluates patients with advanced hip and knee arthritis and helps determine whether robotic-assisted joint replacement may be appropriate.
How Hip and Knee Arthritis Progresses
Osteoarthritis — the most common form of arthritis affecting the hip and knee — is a progressive condition. The cartilage that cushions the joint gradually wears away over time, and once lost, it does not regenerate.
Early
Cartilage Thinning
Joint cartilage begins to wear. Occasional stiffness or discomfort, often after prolonged activity.
Moderate
Cartilage Loss
Noticeable stiffness and reduced range of motion. Activities like golf, stairs, or longer walks become more difficult.
Advanced
Bone-on-Bone
Cartilage is largely or fully worn away. Joint surfaces make direct contact, causing persistent stiffness and limited mobility.
Surgical consideration
Joint Replacement
When non-surgical treatments no longer provide adequate relief and arthritis limits daily function, joint replacement may be appropriate.
Not every patient with arthritis needs surgery. Many patients manage symptoms effectively with non-surgical treatments for years. Joint replacement is considered when the joint has reached a point where those treatments are no longer providing meaningful improvement.
Non-surgical management
When Conservative Treatment May Help
Many patients with hip or knee arthritis initially manage their condition with non-surgical treatments. These approaches can help reduce symptoms and maintain function, though they do not reverse the underlying joint degeneration.
Common non-surgical options include anti-inflammatory medications, corticosteroid or hyaluronic acid injections, physical therapy, activity modification, and assistive devices such as braces or walking aids.
Dr. Avino evaluates each patient’s imaging and function to help determine whether continued conservative management is reasonable or whether surgical consultation is warranted.
Surgical consideration
When It May Be Time for Joint Replacement
Joint replacement may be appropriate when arthritis reaches a point where conservative treatments are no longer providing meaningful relief and the joint is significantly limiting mobility, independence, or quality of life.
Patients often reach this point when they notice that activities they once enjoyed — golf, tennis, walking, travel — have become increasingly difficult or have been given up entirely, and medications or injections are no longer making a sufficient difference.
A consultation allows Dr. Avino to evaluate the joint, review imaging, and discuss whether robotic-assisted joint replacement may be a suitable option.
Joint Replacement Options for Arthritis
The appropriate procedure depends on which joint is affected and the extent of arthritis. Dr. Avino performs all joint replacement procedures using Mako robotic-assisted technology for personalized 3D planning and precision-guided execution.
Robotic Hip Replacement
For advanced hip arthritis. Dr. Avino combines Mako robotic technology with the direct anterior approach for a muscle-sparing procedure that may allow same-day discharge.
Robotic Knee Replacement
For advanced knee arthritis affecting multiple compartments. The Mako system plans implant alignment and joint mechanics based on a 3D model of the patient’s knee.
Mako Robotic Technology
All of Dr. Avino’s joint replacement procedures use Mako robotic-assisted technology. Over 1,000 procedures performed with this system.
Patient Story
Caralu’s Return to an Active Life
After years of hip arthritis limiting her daily activities, Caralu chose Dr. Avino for hip replacement. As a medical professional, she researched her options carefully — and is now back to boating, gardening, and walking without limitations.
Why Patients Choose Dr. Avino
Many patients with advanced arthritis want a surgeon who focuses exclusively on joint replacement and has extensive experience with the robotic technology being used.
1,000+ Robotic Procedures
Over 1,000 robotic-assisted hip and knee replacements performed with Mako technology.
Board-Certified & Fellowship-Trained
Residency at the University of Chicago and fellowship in adult hip and knee reconstruction at Cleveland Clinic.
Focused on Joint Replacement
Dedicated exclusively to hip and knee replacement — evaluating patients from conservative management through surgical candidacy.
Arthritis & Joint Replacement FAQ
How do I know if my arthritis is severe enough for joint replacement?
Severity is evaluated through a combination of imaging (X-rays showing cartilage loss and joint degeneration) and functional assessment (how the arthritis is affecting your mobility and daily life). During a consultation, Dr. Avino reviews both to help determine whether joint replacement is appropriate or whether continued conservative management is a reasonable approach.
Can arthritis be treated without surgery?
Yes. Many patients manage arthritis effectively with non-surgical treatments including medications, injections, physical therapy, and activity modification. These treatments can help maintain function and quality of life, though they do not reverse the underlying joint degeneration. Joint replacement is typically considered when these options are no longer providing adequate relief.
What does “bone-on-bone” mean?
Bone-on-bone describes a stage of arthritis where the protective cartilage within the joint has worn away completely, leaving the bone surfaces in direct contact during movement. This is typically visible on X-rays and is often associated with significant stiffness and limited function.
Should I wait as long as possible before considering surgery?
There is no universal answer. Some patients benefit from waiting while conservative treatments remain effective. However, delaying too long can allow the surrounding muscles to weaken and the joint to stiffen further, which may affect surgical outcomes and recovery. Dr. Avino discusses the optimal timing for each patient during the consultation.
What happens during a consultation?
Dr. Avino reviews your imaging, evaluates the joint, discusses your symptoms and goals, and explains the available treatment options — both surgical and non-surgical. If joint replacement is appropriate, he outlines the procedure, robotic-assisted approach, and expected recovery.
How do I schedule a consultation?
You can request a consultation online or call (561) 694-7776 and ask for Dr. Avino.
Find Out If Joint Replacement May Be Right for You
If hip or knee arthritis is limiting your mobility or quality of life, a consultation with Dr. Avino can help you understand your options and whether robotic-assisted joint replacement may be appropriate.