First performed in 1960, hip replacement surgery is one of the most important surgical advances of our time.
Since then, improvements in joint replacement surgical techniques and technology have greatly increased the effectiveness of this surgery.
Many different types of designs and materials are currently used for artificial hip joints. All of them consist of two basic components: the ball component (made of either ceramic or metal) and the socket component (an outer metal shell with a durable plastic cup).
In a total hip replacement, Dr. Puri will remove the damaged cartilage and bone, then position new metal and plastic joint surfaces to restore the alignment and function of your hip.
Preparing the Bone
Dr. Puri will cut a portion of your thighbone and smooth the surface of your old socket. A new press-fit metal socket is then placed into your pelvis, which may be held in place with screws. The surface of a press-fit prosthesis has tiny pores that your bone will grow into. A press-fit femoral stem is then inserted into your thighbone and once secured, the new ball and socket are joined.
Minimally Invasive Total Hip Arthroplasty
Dr. Puri performs a direct superior 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 Dr. Puri’s Rapid Recovery Protocol for hip arthroplasty, which includes early mobilization, adequate pain control, and aggressive physical therapy. Most patients are able to return to remote work duties within the first two weeks and fully return to work/the office by the three-week mark.
Please speak with Dr. Puri 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 an un-cemented, femoral component. 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. You want the implant 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.
You’ll be admitted to the hospital the day of your surgery, and a member of the anesthesia team will evaluate you. The most common types of anesthesia for hip replacement surgery is a spinal anesthesia with sedation (which allows you to be awake but anesthetizes your body from the waist down). In certain cases, it may be necessary to perform a general anesthetic, which puts you to sleep through the procedure. The team will discuss these choices with you and help you decide which type of anesthesia is best for you.
After surgery, you’ll be moved to the recovery room, where you will remain for 1-2 hours so that your care team can monitor your recovery from the anesthesia. You’ll then be transferred to a private room.
Expect to start walking with an assistive device (crutches or walker) on the day of surgery. You’ll have achieved your therapy goals for safe discharge on the following day.
Your Stay in the Hospital
You’ll stay in the hospital for 1-2 days. After surgery, you’ll feel pain in your hip, and pain medication will help make you as comfortable as possible.
Walking and light activity are important to your recovery and will begin the afternoon of surgery. Most hip replacement patients begin standing or walking with the help of a walking support device and a physical therapist the day of or after the surgery. The physical therapist will teach you specific exercises to strengthen your hip and restore movement for walking and other normal daily activities.
How Your New Hip is Different
You may feel some numbness in the skin around your incision. You may also feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared to the pain and limited function they experience prior to surgery.
Please note that 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.
After your surgery, make sure you:
Participate in a regular light exercise program to maintain proper strength and mobility of your new hip
Take special precautions to avoid falls and injuries. In the event you sustain a fall, please go to the closest emergency room to get evaluated and rule out any fractures
Notify your dentist that you have had a hip replacement. You should be given antibiotics before all dental surgery for the rest of your life
See Dr. Puri periodically for routine follow-up examinations and x-rays