Dr Rob Elliott, Orthopaedic Surgeon
Shoulder, Hip, Knee & Elbow Specialist

Approach to Treatment

Joint Preservation,
Reconstruction & Replacement



Dr Elliott performs joint preservation, reconstruction and replacement when non-operative measures have been exhausted or immediate surgery is required. 

Surgery has the potential to alleviate pain and restore function. However, it is advisable to explore non-operative treatment as many conditions can be treated satisfactorily without surgery and its associated risks. Any surgery can have complications such as infection, and these can be devastating. 

If your pain can be managed by simple pain killers such as paracetamol and occasional anti-inflammatories, then generally this is a safer strategy than surgery.


To achieve a good outcome with a joint, functional range of motion and adequate strength must be achieved. Physiotherapy is an integral part of the treatment pathway. Dr Elliott encourages the use of physiotherapy in order to avoid surgery where possible, and to optimise results after surgery. 

Strengthening and motion are best achieved by regular exercises performed by the patient with intermittent review and supervision by sports physicians or therapists. This is an active process which requires hard work and sometimes causes some pain to the patient. It is important to use pain relief such as tablets, cortisone injections (where appropriate), ice and heat as necessary to minimise pain and allow maximal participation.

Non-operative modalities

Dr Elliott recommends non-operative modalities:

  • Simple painkillers such as paracetamol (very safe and surprisingly effective)
  • Occasional anti-infllammatories
  • Cortisone (anti-inflammatory) steroid injections
  • Weight loss for hip and knee pathology
  • Sports Physician Review
  • Active Physiotherapy – muscle strengthening exercises plus stretching
  • Stationary Cycling
  • Aqua therapy
  • Hot packs
  • Cryotherapy
  • Bracing and orthotics


Additional modalities that can be explored:

  • Visco-supplementation
  • Platelet rich plasma injection
  • Glucosamine and chondroitin supplements