In the Field: Dr. Nicholas Violante embraces a less invasive way to restore function - The Buffalo News

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In the Field: Dr. Nicholas Violante embraces a less invasive way to restore function

Dr. Nicholas J. Violante doesn’t consider himself the black sheep of his family. That would be his youngest brother, Peter.

“He went into financial operations in Virginia,” joked Violante, 33, an orthopedic surgeon who lives in Williamsville with his wife, Melissa, and their children, 2½ and 10 months.

Every other brother, as well as their father and grandfather, either went into dentistry or works at the family medical practice in Lewiston.

Watching Mario Sr. and Mario Jr. run a dental office, not far from the family homestead, set a high standard for all of the kids, Violante said. His brother Mario III works in the family practice, as does brother Jude, a podiatrist. Timothy is at the University at Buffalo Dental School. The sisters also carved noble paths: Olivia as director of a physical therapy department, Marre as a grade school teacher.

Growing up with science-minded elders also led to another important connection for Violante: St. Vincent College, in Latrobe, Pa. He and three of his brothers attended undergraduate school there, as did Dr. Timothy J. Collard, who just before Christmas retired from Excelsior Orthopaedics. Collard’s son and daughter also attended the school and befriended Violante, whom Collard brought into the practice in 2006 and who became partner earlier this month. The other partners invited Violante to take Collard’s office.

“I have a picture of him and I in our office together,” Violante said during a recent interview at the Amherst headquarters of the orthopedic practice, which includes 18 doctors and nearly 200 other employees at sites on Sheridan Drive and in Orchard Park, Niagara Falls and Batavia.

Violante specializes in hip and knee replacement surgery. He does the procedures at Erie County Medical Center using a “Hana table,” a special operating room table that allows him to get at hip bones and joints in a less invasive way. He’ll discuss his work at 6 p.m. Feb. 13 during a free talk at the company’s Amherst headquarters. Reserve a spot by calling 250-6409.

What is it like to grow up in a family of dentists?

It was fun. My dad’s office was pretty much like any other private practice. You’d walk in and there were 10 or 12 patients in the waiting room. I thought it was great. He’d see his patients in the grocery store. It was inspiring. He was providing a service to his community, and people would come up to him and say, ‘My smile looks a lot better,’ ‘My tooth is better.’

Is it happening to you now?

When I was walking in this morning, I saw one of my patients in the physical therapy department, and I’ve run into him something like five times now. In Williamsville, we took a bike ride in the village and saw him after his one knee (replacement), and I saw him at Wegmans after his second knee.

Why did you decide to go into orthopedics as a specialty?

The thing I liked about orthopedics was the surgical aspect of it, restoring function. … When I get a patient come in for hip replacement, I often hear, ‘Thank you. I feel so much better.’ When that happens, it reassures me I went into this specialty for all the right reasons.

Can you talk about the age group you’re dealing with? Is it different for knee and hip?

I would say the average age of my hips is 50, and the average age of my knees is 60. I think people with knee arthritis tolerate it more than people with hip arthritis. Hip arthritis seems to have a dramatic decline. People will have pain, and all of a sudden it becomes urgent. ... Hips routinely have a more rapid recovery; knees tend to take almost twice as long.

Can you describe your ‘anterior hip’ procedure?

The person is laying on their back. The incision is just lateral to the groin on the front of the thigh. The femoral head is removed. I remove the arthritis from the cup – from the acetabulum – and a cup is inserted, and then the leg is lowered to the floor in order to put the femur in the right position to put in the femoral stem. That’s kind of the basics of it. Doing the femur is all about the position of the leg, which is why you need the table. You need to lower the leg down toward the ground to get the femur exposed to an anterior approach. ... The return to function – because you’re not cutting muscle – is considerably quicker during the first two weeks. I tell my patients, at six weeks, everybody’s doing about the same whether you go posterior, anterior lateral or anterior.

Have you ever been in need of an orthopedic surgeon?

I fell and broke my left wrist in Italy and experienced a hospital in Rome. They tried to set my wrist without any type of anesthesia, and it was awful. Then I came home and ended up having surgery at ECMC. It was great. The difference in quality of care between there and here was unbelievable. It was very enlightening to see the difference. After my surgery, I had no pain in my wrist, complete restorative function. It absolutely taught me about patient care. It taught me a lot about pain, what is real pain, and how to treat pain.


On the Web: Read more about Dr. Nicholas J. Violante and his work at

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