Total Hip Replacement FAQ
Does Dr. Puri perform minimally invasive surgery?
Dr. Puri performs a posterior approach minimally invasive total hip arthroplasty. He believes this is the safest and fastest way to recover after a total hip. He will speak with you regarding whether or not you are a candidate for minimally invasive hip arthroplasty. Regardless, all of his patients will participate in the Rapid Recovery Protocol for hip arthroplasty, which includes early mobilization, adequate pain control and aggressive physical therapy. Most patients are able to return to work duties within the first two weeks and return to work/office by the four week mark.
Does Dr. Puri perform the anterior approach?
The anterior approach is an older technique that has recently been modified. It is an approach that, if well done, can be successful. There are absolutely no studies indicating, however, that it is as good nor superior to a posterior approach minimally invasive total hip arthroplasty.
Does Dr. Puri do hip resurfacing?
Dr. Puri does not practice hip resurfacing. Metal on metal bearings have been associated with a significant increase in failure of the implant as well as problems with rejection, hip abscesses and other complications. Furthermore, in the overwhelming majority of cases, hip arthroplasty has the potential to be a more permanent solution than a hip resurfacing. It also eliminates the concern of metal on metal implants.
What kind of implants does Dr. Puri use?
Dr. Puri encourages you to speak with him regarding the choice of implant that he uses. He will select the appropriate implant based on your needs.
Femoral stem: In the overwhelming number of cases, Dr. Puri uses a femoral component that is uncemented. It is designed for active people and allows for bone to grow into the stem and become a permanent part. There are certain situations albeit rare that require cemented stems or the use of "glue" to affix the femoral component. This, however, is not the norm in the practice.
Bearing surface: Dr. Puri also encourages you to discuss with him in detail the choice of bearing surface. Once again, the goal of the implant is for it to last as long as possible and withstand as much activity as possible. In the vast majority of cases, metal or ceramic bearing against a technologically advanced highly cross-linked polyethylene will be the bearing of choice. Dr. Puri does not use metal on metal implants because of a growing number of concerns across North America with regard to its safety.
How long does the surgery take?
Total hip replacement will take about an hour, depending upon the severity of arthritis in your hip.
How long will I be in the hospital?
You will be admitted to the hospital on the day of your surgery and stay the minimum of 2 days and possibly discharged on the 3rd day.
Will I go home after surgery?
You will be in the hospital for 1-2 days. Most of Dr. Puri's patients are discharged home and set up with a home health agency, whereby a nurse will come to your home 2x/week and a physical therapist will come in 4-5x/week. You may be discharged at an earlier time, at which point you will be ready to do outpatient therapy. Some patients who have Medicare may choose to go to a skilled nursing facility, especially if they live alone or have multiple stairs in the home.
What medications do I take after surgery?
After surgery, you will feel soreness in your hip. Medication will be given to make you as comfortable as possible. Dr. Puri prescribes different medications dependent on the patient while you are in the hospital and then for 30 days after discharge.
Will the prosthesis set off metal detectors?
Your new hip may activate metal detectors required for security in airports and some buildings. Tell the security agent about your hip replacement if the alarm is activated.
How long will I have to worry about not bending?
Dr. Puri will typically lift hip precautions at your 1-month visit.
Do I need to take antibiotics for dental procedures?
Following your surgery, you should take antibiotics prior to dental work, including dental cleanings or any surgical procedure that could allow bacteria to enter your bloodstream. Of note, other procedures include colonoscopies and endoscopies.
When will I be able to drive?
You will be able when you are off narcotic pain medication and when Dr. Puri lifts your hip precautions, typically 4 weeks after surgery.
When can I return to work?
Depending on the type of work you do, most of Dr. Puri's patients may resume work within 2-3 weeks.
When can I swim?
You can swim once your incision is fully healed. Dr. Puri will assess the integrity of your incision at your 1 month mark and the decision to get the incision wet/soaked will be made.
When do my staples/sutures come out?
A home health nurse will remove your staples/sutures 2 weeks after surgery and will apply steri-strips (skin tape) to protect your incision.
When can I take a shower? Can I get my incision wet?
You must keep your incision dry and covered until the staples are removed. Thereafter, you can leave it uncovered.
Can I apply creams/lotions to decrease scarring?
Dr. Puri discourages application of any creams or lotions on your incision after surgery as this may cause irritation and inflammation around your incision. Dr. Puri will inform you at your 1 month visit if you can start application of any lotions.
What do I need to do before surgery?
Once you and Dr. Puri have decided on a surgery date, there are a few things you will need to do before surgery.
Pre-operative Medical Evaluation: A medical clearance will be necessary to assess your health and find conditions that can interfere with your surgery or recovery. Several tests, including blood work, EKG, nasal swab, and a history and physical, will be needed prior to your surgery. This medical evaluation will be completed by our pre-operative clinicians or your primary care physician. Please contact Kim or Marie for more information.
Hip Replacement Class: We offer a joint replacement class online and in person. Most of our patients prefer the 40-minute online course for their convenience. Our in-person class takes place at Skokie Hospital in the Abramson Conference Room. Call (847) 933-6762 to reserve a space for the class, which meets at various dates and times.
Who can I contact to schedule or have questions?
For surgery questions or if you would like to schedule surgery you can contact Kim Prado, Dr. Puri's nurse or Marie Albarillo, Dr. Puri's Physician Assistant at (847) 86-ORTHO. To make an appointment with Dr. Puri or for other general questions, please call the general number at (847) 86-ORTHO.
When and how often do I follow up with Dr. Puri?
You will follow up with Dr. Puri or his Physician Assistant, Marie Albarillo 4 weeks after your surgery. You will then follow up at the 4- month mark, 1 year mark and 2 year mark. Please call (847) 86-ORTHO to make your appointment.