Muscle-sparing techniques, personalized implant placement, and AI are helping refine joint replacement surgery 

By Annette Pinder 

For people living with severe hip or knee arthritis, joint replacement can restore mobility and improve quality of life. Christian Curatolo, MD, an orthopedic surgeon specializing in hip and knee replacement at Excelsior Orthopaedics, says that advances in surgical techniques and technology are making these procedures increasingly precise and patient-specific. 

One advancement Dr. Curatolo uses in total knee replacement is a muscle-sparing sub-vastus approach. Rather than cutting through the quadriceps tendon, the surgeon works beneath part of the quadriceps muscle to access the joint. “The goal is to preserve more of the knee’s natural anatomy and soft-tissue attachments,” explains Dr. Curatolo. Preserving these structures may help the kneecap track more naturally after surgery and allow patients to regain quadriceps function sooner. Although research comparing approaches continues to evolve, Dr. Curatolo says his clinical experience has been encouraging. 

Another advancement is kinematic alignment, which takes an individual patient’s anatomy into account when positioning knee implants. Rather than making every reconstructed knee conform to the same alignment, the surgeon uses the patient’s natural anatomy to guide implant placement. “It allows us to personalize the replacement to the individual,” says Dr. Curatolo. 

Artificial intelligence is also helping surgeons better assess how a patient’s bones and surrounding soft tissues interact. Combined with technologies such as robotic assistance for knee replacement and fluoroscopic X-ray imaging during hip replacement, AI can provide additional information to help position implants more precisely. During hip replacement, for example, AI-assisted technology can identify anatomical landmarks on fluoroscopic images, helping surgeons determine where the implant sits relative to the patient’s anatomy. 

Hip replacement is also becoming less invasive. Dr. Curatolo uses the direct anterior approach, which accesses the hip joint by working between muscles rather than cutting through them. For appropriately selected patients, this muscle-sparing technique can facilitate early mobility and recovery, with fewer postoperative movement restrictions. 

Dr. Curatolo performs joint replacements on an outpatient basis at Buffalo Surgery Center. Patients typically spend about five hours at the center, from arrival through recovery, and return home the same day when medically appropriate. Pain management is also evolving. Excelsior is working to minimize opioid use through surgical and anesthesia techniques and newer non-opioid medications, including Journavx (suzetrigine). This can be particularly important for older adults, who may be more susceptible to opioid-related side effects. 

Dr. Curatolo emphasizes that successful outpatient joint replacement involves more than the surgeon. An experienced team of surgical, anesthesia, nursing, and rehabilitation professionals works together to help patients recover safely and comfortably. “We’re getting very good at outpatient surgery,” he says. “It’s the operative techniques, the anesthesia techniques, pain management, and the continuity of having the same team caring for these patients.”

For patients considering hip or knee replacement, these advances offer an increasingly personalized approach focused on preserving tissue, improving precision, managing pain, and helping patients return home and begin recovery sooner.

Learn more about Dr. Curatolo at https://www.excelsiorortho.com/doctor/christian-curatolo-md, where you can also watch a video. To make an appointment, call 716-250-9999.