DEAR DR. ROACH: My husband is 72 years old and on a waiting list for a hip replacement due to severe osteoarthritis. The surgeon he was referred to is quite young, has been performing anterior minimally invasive hip replacements for five years, and does about 250 per year.

Originally we had asked to be referred to a different surgeon who has 30 years of experience, but we were told that older surgeons, although very experienced, do not do this procedure. Instead, they tend to do what they were initially trained to do, which includes cutting through muscle and tendon to access the hip. Apparently this causes a lengthier recovery period. What are your thoughts on this? — D.M.

ANSWER: In general, I do not recommending telling a surgeon which specific type of surgery to perform. You place yourself in the surgeon’s hands and expect to be treated to the best of their expertise. Depending on your particular issues, one type of surgery may be better than another, but only a surgeon can decide this.

I reviewed the published literature on minimally invasive versus conventional surgery. Not everyone is a candidate for the minimally invasive procedure. There are some benefits to minimally invasive surgery such as less postoperative pain, reduced hospital stay, and less blood loss.

However, there has been no consistent benefit shown for rates of infection, the need to revise the procedure, or complications such as dislocation or fracture near the prosthesis. Some studies have suggested a higher rate of nerve injury with the minimally invasive procedure.

Since there are some short-term but no proven long-term benefits to the minimally invasive procedure, I advise you to find a surgeon you trust and listen to their recommendation for the right procedure in your husband’s case.

DEAR DR ROACH: I have a couple issues with my bladder and a sleep aid. I am an 81-year-old male in fairly good health. I have a difficult time getting back to sleep after getting up to empty my bladder. My solution for this was to take a melatonin tablet after each trip back to bed. This seemed to help.

However, I researched melatonin online and found that some people, my wife included, can get nausea and stomach cramps from using melatonin. While this does not happen with me, I’m wondering if taking 3 mg per night could be harmful to me given the reaction my wife gets. — J.T.M.

ANSWER: Although melatonin is generally safe, it can cause some side effects. In addition to the stomach cramps, people have reported vivid dreams or nightmares, short-term depression, dizziness, and headaches. A few people find the medication helpful enough that they are willing to live with these side effects, but many people will give up and try a different treatment for sleep.

If melatonin isn’t causing you any side effects, then it is likely safe for you. Many people use melatonin, and although long-term safety has not been proven by trials, it is increasingly unlikely that any long-term adverse effects haven’t been discovered.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved