Lalit Puri, M.D.

Profile

Personal Bio

Treatment Philosophy

My team is built around providing the highest quality of care to our patients. We provide expertise managing conditions of the hip and knee. We feel that education is a key component of treatment and will work to customize the best solution for you to ensure the best outcomes.

Personal Interests

I enjoy coaching my kids, travel, tennis and my family.

CV/Resume

Conditions & Procedures

Conditions

Adult Hip Diseases, Arthritis of the Hip, Arthritis of the Knee, Avascular Necrosis, Hip Dysplasia, Hip Osteoarthritis, Knee Osteoarthritis

Procedures

Computer Assisted Surgery, Custom Knee Replacement, Joint Replacement, Minimally Invasive Approach, Minimally Invasive Hip Techniques, Minimally Invasive Knee Techniques, Partial Knee Replacement, Patellofemoral Replacement, Total Hip Replacement and Revision Surgery, Total Knee Replacement and Revision Surgery, Unicompartmental Knee Replacement

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Languages

English

Board Certified

Orthopaedic Surgery

Clinical Service

Education, Training & Fellowships

Medical School

Northwestern Feinberg School of Medicine, 1995

Residency

Northwestern Feinberg School of Medicine, 1996

Fellowship

New England Baptist Hospital, 2001

Locations

A

NorthShore Medical Group

9650 Gross Point Rd.
Suite 2900
Skokie, IL 60076
847.866.7846 866.954.5787 fax This location is wheelchair accessible.
B

NOI NorthShore Orthopedics Glenview

2501 Compass Rd
Ste 125
Glenview, IL 60026
847.866.7846 866.954.5788 fax This location is wheelchair accessible.

Insurance

Every effort has been made to ensure the accuracy of the information in this directory. However, some changes may occur between updates. Please check with your provider to ensure that he or she participates in your health plan.

Aetna HMO/PPO/POS
BCBS HMOI
BCBS PPO *except Blue Choice IL
Beechstreet PPO
CCN PPO
CIGNA Choice Fund
CIGNA Choice Fund PPO
CIGNA EPO
CIGNA Network
CIGNA Network Open Access
CIGNA POS
CIGNA POS Open Access
CIGNA PPO
CIGNA:Open Access Plus
First Health PPO
Galaxy PPO
Great West POS
Great West PPO
Healthcares Finest Network PPO
Humana Choice Care PPO
Humana IPA--HMO
Humana POS
Humana PPO
Land of Lincoln
Medicare
Multiplan Admar PPO
Multiplan Formost PPO
Multiplan Health Network PPO
Multiplan Wellmark PPO
NorthShore Employee Network I (EPO Option)
NorthShore Employee Network II (EPO Plus & CDHP)
PHCS PPO
Preferred Plan PPO
Railroad Medicare - Cook County
Railroad Medicare - Lake County
UHC *except Core & Navigate
Unicare PPO

Publications

  • A dose-ranging study of 0.5% bupivacaine or ropivacaine on the success and duration of the ultrasound-guided, nerve-stimulator-assisted sciatic nerve block: a double-blind, randomized clinical trial.

    Regional anesthesia and pain medicine

    Authors: Nader A,
    Abstract
    Before bifurcation, the sciatic nerve is composed of 2 component nerves encased in a common investing extraneural layer (CIEL). We examined the effect of various volumes injected beneath the CIEL on the success and duration of sciatic nerve block.
    Ultrasound-guided nerve-stimulator-assisted sciatic nerve blocks were performed on 142 subjects. Subjects were randomized into 14 groups (0.5% ropivacaine or bupivacaine) with epinephrine 1:300,000 in volumes ranging from 2.5 to 30 mL. Successful block was defined as a complete sensory and motor block at 60 minutes. The minimum threshold current, time to complete block, duration of sensory and motor block, postoperative pain, and analgesic requirements were recorded.
    The mean threshold current external to the CIEL was 0.52 (0.15) mA compared to 0.19 (0.09) mA beneath the CIEL (P < 0.001). Successful block was achieved in 30 of 40 subjects that received 5 mL or less of ropivacaine or bupivacaine compared with 97 of 99 that received 10 mL or greater volume (P = 0.006). Injection volumes greater than or equal to 10 mL produced complete sensory and motor block within 30 minutes. Volumes greater than 10 mL did not extend the duration of the sensory or motor block. Injection volumes of 2.5 and 5 mL were associated with delayed onset and decreased block duration and a greater fraction of subjects experiencing pain behind the knee.
    Injecting 10 mL of 0.5% bupivacaine or ropivacaine below the CIEL produces comparable onset and duration of sensory and motor blockade as volumes as large as 30 mL.
    PMID: 24108248 [PubMed - as supplied by publisher]
  • Understanding readmission after primary total hip and knee arthroplasty: who's at risk?

    The Journal of arthroplasty 2014 Feb

    Authors: Saucedo JM,
    Abstract
    Readmission has been cited as an important quality measure in the Patient Protection and Affordable Care Act. We queried an electronic database for all patients who underwent Total Hip Arthroplasty or Total Knee Arthroplasty at our institution from 2006 to 2010 and identified those readmitted within 90 days of surgery, reviewed their demographic and clinical data, and performed a multivariable logistic regression analysis to determine significant risk factors. The overall 90-day readmission rate was 7.8%. The most common readmission diagnoses were related to infection and procedure-related complications. An increased likelihood of readmission was found with coronary artery disease, diabetes, increased LOS, underweight status, obese status, age (over 80 or under 50), and Medicare. Procedure-related complications and wound complications accounted for more readmissions than any single medical complication.
    PMID: 23958236 [PubMed - as supplied by publisher]
  • Impact of preoperative myocardial infarction on surgical outcomes in inpatient orthopaedic surgery.

    International orthopaedics 2013 Dec

    Authors: Lim S,
    Abstract
    The purpose of this study was to evaluate the impact of a preoperative myocardial infarction (MI) on outcomes of inpatient orthopaedic operations.
    The National Surgical Quality Improvement Program database was used to identify patients who underwent common orthopaedic operations from 2006 to 2010. Patient demographic data, comorbidities, complications, and lengths of stay were collected. Multivariate logistic regression and linear regression models were used to compare outcomes for patients with and without a history of MI in the six months prior to surgery.
    Of the 32,462 patients identified, 86 had sustained an MI in the six months prior to surgery. The MI cohort had no cardiac complications but had increased incidences of superficial surgical site infection, unplanned re-intubation, ventilator-assisted respiration for more than 48 hours, pneumonia, sepsis or septic shock, and postoperative mortality within 30 days of surgery, as well as prolonged lengths of stay. Following logistic regression to adjust for baseline differences, a history of MI showed no association with cardiac complications and was significantly associated with superficial surgical site infection (OR 3.6, 95% CI 1.1-11.8), ventilator dependence for over 48 hours (OR 4.0, 95% CI 1.1-14.0), and extended length of stay (median with interquartile range 4 [4-4] vs. 5 [5-5] days).
    A myocardial infarction within six months prior to orthopaedic surgery is not associated with a higher risk of 30-day perioperative cardiac complications; however, it is associated with increased rates of surgical site infection, prolonged ventilator dependence, and longer hospital stay.
    PMID: 23860790 [PubMed - as supplied by publisher]
  • How accurately are we coding readmission diagnoses after total joint arthroplasty?

    The Journal of arthroplasty 2013 Aug

    Authors: Saucedo J,
    Abstract
    Readmission rates have been cited as an important quality measure in the Affordable Care Act. Accordingly, understanding and accurately tracking the causes for readmission will be increasingly important. We queried an electronic database for all patients who underwent primary THA or TKA at our institution from 2006 through 2010. We identified those readmitted within 90 days of surgery and analyzed 87 random de-identified medical records. We then assigned a clinical diagnosis for each readmission, which was then compared with the coder-derived diagnosis by ICD-9 code. The overall 90-day readmission rate was 7.9%. We identified 22 of 87 patients for whom there was disagreement (25.3%, 95% CI=16.6-35.8%). The most common were procedure-related complications. Coded diagnoses frequently did not correlate with the physician-derived diagnoses. The unverified use of coded readmission diagnoses in calculating quality measures may not be clinically relevant.
    PMID: 23768916 [PubMed - as supplied by publisher]
  • Demonstration of saw blade accuracy and excursion: a cadaveric comparison study of blade types used in total knee arthroplasty.

    The Journal of arthroplasty 2013 Jun

    Authors: Wetzel RJ,
    Abstract
    In total knee arthroplasty, outcomes partly depend on accurate osteotomies and integrity of stabilizing structures. We compared accuracy and excursion between a conventional and an oscillating tip saw blade. Two sets of osteotomies were made on cadaveric knees. Bi-planar accuracy was compared using computer navigation, and excursion was compared using methylene blue. Wilcoxon-Mann-Whitney testing demonstrated no significant difference in blade accuracy (p=0.35). Blades were within 0.5 degrees of neutral coronally and 2.0 degrees sagittally. The oscillating tip blade demonstrated less dye markings on the surrounding tissues. Accurate osteotomies and soft tissue protection are critical to successful arthroplasties. Although comparative accuracy was equal, the oscillating tip blade exhibited less excursion displaying potential for less iatrogenic soft tissue injuries leading to catastrophic failure.
    PMID: 23523505 [PubMed - as supplied by publisher]
  • Single-use instrumentation, cutting blocks, and trials decrease contamination during total knee arthroplasty: a prospective comparison of navigated and nonnavigated cases.

    The journal of knee surgery 2013 Aug

    Authors: Mont MA,
    Abstract
    The purpose of this prospective controlled trial was to determine whether decrease in contamination could be achieved in nonnavigated and navigated total knee arthroplasties by replacing traditional saws, cutting blocks, and trials with specialized saws and single-use cutting blocks and trials. Various tray wrapping metrics during total knee arthroplasty were measured in 400 procedures performed by 8 different surgeons at 6 institutions. Instrumentation contamination was determined by counting the number of tray sterility indicators, pans, and instruments that were compromised. The results show that a decrease in contamination was evident in 57% (nonnavigated) and 32% (navigated) fewer compromises of tray sterility indicators, pans, and instruments. Single-use instruments show promising benefits, but further study is needed to confirm safety and efficacy before they can be widely adopted. The authors believe that the use of single-use instruments, cutting guides, and trial implants for total knee arthroplasty will play an increasing role in decreasing operating room contamination and potential deep infections.
    PMID: 23359398 [PubMed - as supplied by publisher]
  • Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure.

    Orthopedics 2012 May

    Authors: Patel RM,
    Abstract
    Various methods of skin closure exist in joint replacement surgery. Although subcuticular skin closure techniques offer an aesthetic advantage over conventional skin stapling, no measurable differences have been reported. Furthermore, newer barbed sutures, such as the V-Loc absorbable suture (Covidien, Mansfield, Massachusetts), theoretically distribute tension evenly through the wound and help decrease knot-related complications. The purpose of this study was to evaluate whether wound complication rates were (1) lower in V-Loc closure cases as theoretically suggested, (2) lower for subcuticular closure vs staples, and (3) significantly different for knee and hip joint reconstruction.A retrospective chart review was conducted of 278 consecutive cases of primary joint reconstruction performed by a single surgeon (L.P.). The study group comprised 106 men and 161 women. Average patient age at surgery was 63 years (range, 18-92 years), and average body mass index of the cohort was 33.7 kg/m(2) (range, 25-51 kg/m(2)). Skin was closed via staple gun or subcuticular stitch (3-0 Biosyn [Covidien] vs V-Loc). Seven (3.9%) wound complications occurred in 181 cases closed with staples. Four (7.8%) wound complications occurred in 51 cases closed via subcuticular Biosyn suture. Six (13.0%) wound complications occurred in 46 cases closed with V-Loc suture. The staple group had a lower rate of complications when compared with the suture group as a whole (P=.033) and when compared specifically with the V-Loc suture group (P=.017).
    PMID: 22588404 [PubMed - as supplied by publisher]
  • Computer-assisted total knee arthroplasty for significant tibial deformities.

    The Journal of arthroplasty 2013 Jan

    Authors: Shah RR,
    Abstract
    Computer-assisted total knee arthroplasty has been demonstrated to provide reproducible limb mechanical alignment within 3° from the neutral mechanical axis. However, restoring proper implant and extremity alignment remains a significant challenge with proximal tibial deficiencies. In this prospective study, we describe the use of computer navigation to quantify the amount of bone loss on the medial or lateral tibial plateau and the use of these data to assess the need for augmentation with metallic tibial wedges. In this study, we demonstrate that computer-assisted total knee arthroplasty in patients with significant tibial deformities can accurately measure severe tibial deformities, predict tibial augment thickness, and provide excellent mechanical alignment and restore the joint line without excessive bony resection, repeated osteotomies, and repeated augment trialing.
    PMID: 22503336 [PubMed - as supplied by publisher]
  • Complications of femoral nerve blockade in total knee arthroplasty and strategies to reduce patient risk.

    The Journal of arthroplasty 2012 Apr

    Authors: Lareau JM,
    Abstract
    Femoral nerve catheters are widely used for analgesia in total knee arthroplasty. Although evidence suggests that catheters improve pain control and may facilitate short-term rehabilitation, few reports exist regarding their complications. This case series explores the experience of femoral nerve catheter use at high-volume orthopedic specialty hospitals. Serious complications including compartment syndrome, periprosthetic fracture, and vascular injury are reported. The authors support femoral nerve catheter use with appropriate precautions taken to reduce risk of patient falls, vascular injury, and wrong-site surgery.
    PMID: 21908171 [PubMed - as supplied by publisher]
  • The lateral compartment in knees with isolated medial and patellofemoral osteoarthritis: a histologic analysis of articular cartilage.

    The Journal of arthroplasty 2011 Aug

    Authors: Moen TC,
    Abstract
    The purpose of this study was to examine, at a histologic level, the articular cartilage of the radiographically normal lateral compartment in knees with isolated medial and possibly patellofemoral osteoarthritis. Twenty patients with radiographic evidence of medial compartment osteoarthritis and a radiographically osteoarthritis-free lateral compartment underwent a tricompartmental total knee arthroplasty. The resected lateral femoral condyle and lateral tibial plateau were evaluated by a fellowship-trained musculoskeletal pathologist for the presence, or lack thereof, of osteoarthritis at a microscopic level. Both the tibia and femur showed evidence of mild osteoarthritis at a microscopic level. This study shows that in patients with radiographic evidence of medial osteoarthritis and a radiographically normal lateral compartment, there is mild osteoarthritis in the lateral compartment.
    PMID: 20801614 [PubMed - as supplied by publisher]

In the News

Mar 2014

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