Dr. Gilbert Interview S.F., CA

1.) Hi Dr.Gilbert, can you please first start out by telling us how you got started with Hip Resurfacing and give us a little background on your experience as a surgeon.  Where did you train for hip resurfacing?  Who trained you? 

McMinn

2.)   Do you do the neck capsule preservation technique in your surgeries?

yes

3.)  Do you re-attach the gluteus tendon?

yes

4.)  Which approach do you prefer to use anterolateral or posterior?

posterior

5.)  What size do your incisions normally range in inches?

Small as possible depending size of patient. 4 to 6 inches

6.)  What is your opinion on the Direct Anterior approach for hip resurfacing, not the antero-lateral approach where the incision is on the side but the Direct Anterior approach?

Ok but not necessary

7.)   How long do you feel it takes for the bone to be fully healed, actually grow into the prosthesis?

3 to 6 months depending on the patient

8.)   Barring any complications, how many days in the hospital will a patient normally stay?

2 or 3 days

8.)   What is your typical rehab protocol?  90 degree restriction? Walker” Crutches Cane? amount of time?  Blood thinners?  TED stockings?  Ice?  PT?

2 crutches for 1 month for women; 2 weeks for men; no rom restrictions; asperin for 4 to 6 weeks

9.)   How long before a typical patient is allowed to drive a car, return to work?

As soon as they want. Jon Dickinson was back to work in 13 days

10.)   What is the recommended time you tell your patients before they can start to run again/do  impact sports?  Are there any sports you don’t want your patients to participate in after surgery?  Out of the patients you have resurfaced what are some of the sports they have returned to?

Run after 6 months. Sports include ice hockeys, skiing, tri athelon, marathon, martial arts, ballet

11.)   What is your take on cementless (femoral) devices for resurfacing? 

Haven’t used

12.)   Do you have a cut off age for resurfacing patients or do you go on a case by case basis?

Case by case. Oldest 86 because femur was deformed from prior fracture

13.)   What type of anesthesia do you use general or epidural or ? 

spinal

14.)     Are there any cases that you will not take in particular, AVN, dysplasia, small cysts. 

Maybe touch on some of the very difficult cases you have been able to resurface.  Large cysts and severe AVN

15.)     Do you do bilateral surgeries same day, if not how far apart do you recommend? 

Same day

16.)  What device do you prefer to use for hip resurfacing and why?

S & N Birmingham. It works and is released by FDA

17.)     If you can’t perform a hip resurfacing – what THR device do you prefer and why?

Depuy Summit. Excellent prosthesis

18.)     What do you consider an adequate number of surgeries for a doctor to be proficient at hip resurfacing?

 50