SALT LAKE CITY, Utah – For people suffering from hip pain that prevents them from enjoying their daily life, summertime and all the recreational activities it has to offer here in Utah can highlight the need for patients to consider medical intervention.
Dr. Brant Nikolaus – a fellowship-trained and board-certified orthopedic surgeon with Salt Lake Orthopedic Clinic at St. Mark’s Hospital – joined FOX13’s The PLACE Tuesday to talk about all of the options patients have when they’re experiencing hip pain.
“A lot of times people are worried about going to an orthopedic surgeon right off the bat because they think, ‘Oh well, they're going to want to do surgery.’ That's not the case,” Dr. Brant Nikolaus explained. “For me, I treat patients and not x-rays. For me, I start with the conservative measures first and foremost. Once we have exhausted all those options and if you meet criteria, that's when we go forward with surgery.”
Dr. Nikolaus stresses that each patient is an individual. He says he treats a wide range of patients and develops a different care plan, tailored to each patient, based on their individual needs and based on multiple considerations.
· RELATED: Why Younger People Get Hip Replacements
How do you know if it’s time to see a medical professional about your hip pain to consider replacement? Dr. Nikolaus says people should book an appointment with him when they have hip pain that's affecting their daily life.
“A pain here and there is very normal, but when it's affecting your activities of daily living – then I think it's good to see a specialist to see what's going on,” Dr. Nikolaus said.
The criteria for hip replacement surgery typically include, but are not limited to:
- Degenerative Arthritis
- Rheumatoid Arthritis
- Severe Pain & Disability
- Failure of Conservative Treatments (like medication or physical therapy)
- Other Conditions (including hip fractures or bone tumors)
“Direct Anterior” Hip Replacement: A Minimally-Invasive Approach
While Dr. Nikolaus is well-versed in all the different approaches to hip replacement, the one he feels strongest about using – the approach he prefers – is known as “direct anterior” hip replacement.
“It’s a muscle sparing approach,” Dr. Nikolaus explained. “With the direct anterior approach, you don’t cut any muscles, you go between them. You stretch them a little bit. You do a small incision – about 10 centimeters or so – and you get to the hip through the muscles, not by cutting into them.”
Again, this approach involves only a small incision – whether that’s a standard or bikini incision.
Dr. Nikolaus uses a specialized surgery table – a unique patient positioning device – that results in the success of a multitude of orthopedic procedures.
“The patient is supine, lying flat on their back, and that way, I can actually manipulate the leg into a specific position so I can get better exposure,” he said. “Also with the table, I'm able to use x-ray intraoperatively. With the fluoroscopic imaging, I'm able to see exactly what’s going on and make sure I reproduce the offset and the length – make your leg lengths right where they're supposed to be by matching the other side – and then you're also able to test the stability with this table.”
Because direct anterior hip approach is minimally-invasive – especially when considering the smaller incisions involved – patients tend to experience a faster, less painful recovery. Benefits also include preserved muscle function, less blood loss, less damage to surrounding muscles and soft tissue, and a lower risk of hip dislocation after surgery.
“Patients do very, very well with anterior hip replacements,” Dr. Nikolaus added. “Most people stay just one night in the hospital. Patients are up, walking the same day as surgery with physical therapy. I like people to be on two crutches or a walker until they can walk without pain and then a single crutch or a cane until they can walk without a limp.”
Dr. Nikolaus says most patients return to his office in two weeks and they’re walking without any type of assistance! Most patients are off pain medications at that point, too.
“People do better by getting up faster and getting home quicker,” he said.
Salt Lake Orthopedic Clinic
The Salt Lake Orthopedic Clinic is located on the campus of St. Mark’s Hospital. Orthopedic conditions treated at St. Mark’s Hospital include, but are not limited to:
- Arthritis
- Back pain
- Fractured hips and other bones
- Nerve pain
- Neuropathy (nerve damage)
- Sciatica
- Scoliosis
- Whiplash
The orthopedic surgeons and specialists at Salt Lake Orthopedic Clinic have a 30-year history of providing care in the Salt Lake City area. As one of the area's first orthopedic centers, the team offers many services for bone, joint and muscle conditions, including arthritis, back pain and whiplash. The clinic also offers advanced treatments, including knee and hip replacements and shoulder reconstruction.
Salt Lake Orthopedic Clinic
1160 E. 3900 S., Suite 5000
Salt Lake City, UT 84124
For more information about hip or knee replacements, visit SaltLakeOrthopedics.com or schedule an appointment by calling (801)261-7479.
· RELATED: Free From Pain Thanks to Salt Lake Orthopedic Clinic at St. Mark’s Hospital
About O. Brant Nikolaus, MD
Dr. Brant Nikolaus completed his undergraduate studies at the University of Utah before attending the world-renowned Mayo Clinic College of Medicine in Rochester, Minnesota for both medical school and orthopedic surgery residency. He later completed a fellowship in advanced hip and knee reconstruction at OrthoCarolina Hip and Knee Center in Charlotte, North Carolina.
Dr. Nikolaus specializes in hip and knee reconstruction, including primary hip and knee replacement, partial knee replacement and complex revision hip and knee reconstruction. For Dr. Nikolaus, the patient always comes first. This philosophy of care was engraved in him during his time with the Mayo Clinic and is evident as he passionately identifies and fixes the orthopedic challenges facing each patient.
Dr. Nikolaus calls both Arizona and Utah "home" as he grew up in rural Arizona and moved to Utah in high school. The 4th of 8 children, he was the first in his family to graduate from college. Dr. Nikolaus is married to his high school sweetheart and is the proud father of three daughters and one son. He is an accomplished singer and enjoys participating in Spartan Races, training at the gym, watching and playing different sports and enjoying the outdoors with his family.
St. Mark’s Hospital is one of eight MountainStar Healthcare hospitals in Utah.
