More About Dr. Dalury
Dr. David Dalury is a graduate of Dartmouth Medical School. He did his residency and fellowship at the Harvard Hospitals, where he was trained in total joint replacement surgery. He is a Clinical Professor of Orthopedic Surgery at University of Maryland Medicine and Chief of Orthopaedics at University of Maryland St Joseph Medical Center. He is a member of numerous medical societies and associations and has written extensively for peer-reviewed publications. In addition, Dr. Dalury resides as an active member of The Knee Society, an elite group of orthopaedic surgeons charged with the advancement of care to patients with knee disorders through leadership in education and research.
Dr. Dalury is a Top Doc in Orthopaedic Surgery as listed with Castle Connolly.
Excellent source for information regarding Total Knee Replacement and Total Hip Replacement (Click AAHKS logo):
Has Your Orthopaedic Surgery Been Postponed Due to COVID-19?
We understand the concern and disruptions that the COVID-19 crisis has posed upon our patients. As we all continue to do our part to contain and prevent the spread of COVID-19, you can be assured that we are still continually striving to provide our patients with helpful resources and information to help navigate their needs during this time. Some patients may have had an interruption to their scheduled orthopaedic surgery and may be experiencing hardship in managing symptoms. Here is an article from the American Academy of Orthopaedic Surgeons (AAOS) that may help to manage those symptoms while we wait for things to return to normal. What to Do If Your Orthopaedic Surgery Is Postponed . Here is an article, as well as, videos posted below for those who may be suffering from hip or knee conditions. COVID-19: Preparing For or Recovering From Hip or Knee Replacement
Helpful AAHKS Hip & Knee Replacement Videos
Articles of Interest to Dr. Dalury’s Patients
Additional Patient References
Additional Printable PDFs
Frequently Asked Questions
Is this the right implant for me?
Implant design and innovation continues to develop with technological advances in imaging, implant materials and computer modeling. Implants today are leaps and bounds ahead of their counterparts from 20 years ago in regards to durability and performance. Marketing for these implants has also exploded as implant manufacturers are now going directly to the patients with “gender specific” or high performance “athlete” implants. In general, implants used today by orthopedic surgeons are very durable and will help patients regain function regardless of the marketing behind them. Implants in general fail at a rate of about 1% a year meaning that at year 10 there is a 90% chance the joint is still working well and an 80% chance it is still performing at year 20. Entrust your surgeon to analyze the data versus the marketing hype and determine what particular implant will work best for your demands and anatomy.
Can I get a custom implant?
Custom implants have shown no increase in durability or function and in some studies, demonstrated poorer outcomes. One size does not fit all, but modern implants have great versatility and sizing options available for your surgeon. Preoperative radiographs and other imaging tools are utilized by your surgical team to ensure the proper implant and size are available.
Can I choose the implant that I receive?
Speak to your surgeon if you have specific requests for your implant. Typically, surgeons have a few manufacturers and models that they prefer and have spent hundreds or even thousands of surgeries honing their skills with that particular instrumentation. It would not be advisable to switch based on some great marketing material you came across in a magazine or the internet. Within their arsenal, your surgeon will have an implant that will meet your expectations.
Rotating platform versus fixed bearing?
This refers to the polyethylene bearing placed in the knee between the two metal components. Some patients refer to this as their new “meniscus or cartilage”. Traditionally, the polyethylene locks into the metal tray and is referred to as a “fixed bearing”. A rotating platform or mobile bearing allows the polyethylene to rotate independently from the metal tray. Theoretically, a rotating platform or mobile bearing would reduce wear of the polyethylene and more closely mimic the movement of the patient’s natural knee. Studies performed have not shown an advantage in patient satisfaction, durability or function between the two options. The rotating platform has been marketed as an “athlete’s knee” or the “golfers knee”.
Will my surgeon use a robot?
The use of newer technologies such as robots is at the discretion of the surgeon. At this time, no studies have demonstrated improved outcomes with robotic assistance. These surgeries typically are considerably more expensive as well as longer in duration. As technologies continue to develop, robotic assistance will begin to play a more integral part of the surgical process.
What is my implant made of?
The vast majority of the implants available on the market are composed of surgical stainless steel and highly crosslinked polyethylene. This high quality steel is composed of chromium, cobalt and nickel. These metals are found to have great durability and are typically very inert in the body. Implants no longer employ metal on metal bearing surfaces like they did in the past. These “old style” implants could cause metal ion buildup in the tissues surrounding the implant and ultimately cause failure. These issues have been resolved with newer more advanced bearing surfaces.
What if I’m allergic to metal or have a metal sensitivity?
It is not uncommon for patients to have skin metal sensitivities that typically arise from contact to jewelry or eyeglasses. This DOES NOT imply that you will have a similar reaction to the implant in your body. There has been no indication that patch skin testing or blood tests to determine metal allergies are beneficial to determining whether you will have an adverse reaction to the implants. If you have concerns in regards to metal sensitivity or allergy to your implant, talk with your surgeon to determine if an alternate implant may be necessary.
Have any of the implants being used in my surgery been recalled?
No, we cannot use any implants that have been recalled. All implants used are FDA approved and have not been part of a recall in the past. We will keep the serial numbers and implant information and you will be contacted according to federal law if any of your implants were to be recalled in the future.
Will my leg length be affected by my surgery?
Typically there will be no distinguishable difference in leg length following total hip or knee replacement. The collateral ligaments around the knee are preserved thus making it difficult to lengthen or shorten a leg after total knee replacement. If the patient was afflicted with a very knock kneed (valgus) or bowed knee (varus) preoperatively, then the leg may feel longer postoperatively. In total hip replacement length differences are a risk. They are rare and typically do not require any treatment or intervention. In order to insure a stable hip it is sometimes necessary to lengthen a leg slightly.
Does Dr. Dalury actually do my surgery?
Yes, Dr. Dalury will be the one conducting your indicated surgery. He utilizes a team of skilled physician assistants, nurses and orthopedic surgical techs to assist him in the operating room during his cases. He currently does not participate in the training of orthopedic fellows, but occasionally has orthopedic surgical residents participate for educational purposes. He has spent over 30 years developing his surgical skills and building his reputation as a world class hip and knee replacement specialist. It will be his hands that handle the intricacies of your particular case.
Research, Current Studies
Dr. Dalury is very interested in medical research. He maintains a database that stores information about the implants that he uses. Regular periodic X-ray examination is important to monitor the prosthesis’ fixation, and potential wear of the plastic and metal articulations. These X-rays enable Dr. Dalury to compare to the previous ones and check outcomes of the total joint replacement. Dr. Dalury recommends follow-up examinations at approximately six weeks postoperatively, followed by approximately twelve weeks, one year and then every two to three years. This information is strictly confidential and, as with all medical records, is never shared without your permission. You may be approached, on occasion by Dr. Dalury and his staff, to participate in specific research studies. These studies are strictly voluntary. They follow specific and strict guidelines and protocols, and will require your informed consent if you decide to participate.
For questions regarding clinical research please contact:
New Presentations at National Meetings (2018-2019)
“Polyethylene only revisions have excellent outcomes in revision total knee” presented at the Knee Society and the American Association of Orthopedic Surgeons (AAOS), 2018.
“Ignore the patella in revision total knee” presented at the American Association of Hip and Knee Surgery (AAHKS) meeting, 2018. PDF Opens in New Window
“Femoral stems are tolerant of malposition” presented at the AAHKS meeting, 2018. PDF Opens in New Window
“Narcotic usage in a group of patients undergoing TKR” presented at the AAHKS meeting, 2018. PDF Opens in New Window
“Update on THR” and “Pain Management following TKR” and the role of robots in THR to be presented at AAOS, 2019.
“The Natural History of Radiolucencies following Uncemented TKR at 9 Years” presented at AAOS, 2019. PDF Opens in New Window
Head of AAHKS Patient Education Committee, 2008-2017
Clinical Professor of Orthopaedics at University of Maryland Medicine 2013 to present
Adult Reconstruction Knee Program Subcommittee, 2008 to 2011
University of Maryland St. Joseph Medical Center, Associate Medical Staff, Department of Surgery, Division of Orthopaedics, December 1990
Chief, Orthopaedic Surgery, University of Maryland St. Joseph Medical Center, 2003 to present
Chief, Adult Reconstructive Surgery, University of Maryland St. Joseph Medical Center, 1995 to present
Division of Orthopaedic Surgery, September 1991
Professional Organization Memberships