10 Questions to Ask Your Hip Preservation Surgeon

Advice from Benedict Nwachukwu, MD, MBA — Orthopedic Hip Specialist in NYC

If you’re considering hip preservation surgery for issues like femoroacetabular impingement (FAI), labral tears, or chronic hip pain, knowing what to ask can make all the difference.

“As an athlete and active individual, I want patients to feel as informed, confident, and empowered as I would like to be when making decisions about orthopedic care.”

Here are ten important questions I hear often — and how I answer them in my own practice:

1. What is your experience with hip preservation surgery?

Not all orthopedic surgeons are trained in hip joint preservation techniques, many almost exclusively focus on hip replacement procedures. In fact, a majority of orthopedic surgeons perform replacements rather than preservation surgeries like hip arthroscopy. Advanced training in a different skillset for minimally invasive techniques is required for hip preservation surgeries.

My training at Hospital for Special Surgery and Rush University focused on hip arthroscopy, sports medicine, and joint preservation procedures. I’ve performed hundreds of hip preservation procedures and actively publish research to help advance the field.

2. Do you perform postless hip arthroscopy? Why is it significant?

Yes — I perform a postless technique on a regular basis. Traditional hip arthroscopy utilizes a padded post placed between the legs to separate the hip joint for surgery, which has the potential to compress the groin and even put the nerves at risk of damage. In postless surgery, we utilize advanced traction and patient positioning to avoid that altogether. It’s safer and more comfortable for the patient, but it is not offered by all surgeons since it requires special equipment and experience.

3. Do I need a second opinion before surgery?

Absolutely. I encourage second opinions, especially for patients who’ve been told that they have no option but a hip replacement. I’ve seen numerous patients who are amazed to learn they still qualify for hip preservation procedures to delay hip replacement after years of pain.

4. How do you determine if I’m a candidate for hip preservation vs. hip replacement?

Age is not the sole factor. I take into account each patient’s imaging, activity level, cartilage condition, and future aspirations. Most patients in their 40s or even 50s who are active are great candidates for arthroscopic joint-sparing procedures.

5.What specifically do you do for labral tears or FAI?

My goal is always to restore and preserve function. I typically repair the labrum, rather than remove it, and remodel bone in the setting of cam or pincer impingement. These procedures alleviate chronic pain while preserving a healthy and stable joint.

6. What will my recovery be like?

Recovery varies, but I create a personalized plan for every patient. Most start physical therapy right away, and I stay involved throughout the rehabilitation period. My team and I work hand in hand with therapists to get you moving safely and confidently.

7. What non-surgical options do you recommend before considering surgery?

Surgery is not the first resort. We typically try physical therapy, guided injections, and activity modification before we go to the operating room. I only recommend surgery when we’ve tried other things and it’s clear that it will be of great value.

8. Will you be performing the surgery yourself?

Yes. I personally perform all my surgeries myself. While I might operate with residents or fellows at academic centers, I’m always the primary surgeon and participate in all aspects of your care.

9. What is your complication rate, and how do you handle unexpected problems?

I believe in transparency. While complications are rare, we monitor each outcome and follow evidence-based protocols to reduce risk. If the unforeseen occurs, we manage it effectively and compassionately, communicating with our patient every step of the way.

10. Do you engage in orthopedic research or innovation?

Yes. I’m a faculty member at Weill Cornell Medicine and regularly publish research on hip preservation, surgical technique, and outcomes. Staying involved in research helps me provide patients with the most up-to-date and effective care.

Ready to Schedule a Consultation or Second Opinion?

Whether you are exploring your options or looking for a definitive treatment plan, I am here to help. If you are unsure if surgery is right for you, or want to confirm your options, a second opinion is a great next step!