Local orthopaedic expertise goes national

Physician Assistant Tom Lewandowski showing MCO research findings on knee replacements

From 2005 to 2030, total joint replacements are expected to increase dramatically. Total hip replacements are projected to increase by 174 percent, total knee replacements by 678 percent! Revisions of knee replacements will increase by 601 percent.

“Knee replacement revisions are going to dramatically increase across the country as many of the knee replacements done in years past begin to wear out,” explained Dr. Erik Severson, orthopaedic surgeon who serves as Total Joints Program Medical Director and oversees the Rapid Recovery Program, a leading edge joint replacement protocol with proven outcome enhancements for patients, at Minnesota Center for Orthopaedics (MCO) at Riverwood Healthcare Center in Aitkin and Cuyuna Regional Medical Center in Crosby. “Over the past decade In Aitkin and Crosby, we’ve seen tremendous growth already. In 2010, they performed 96 total joint replacements; this number grew to 551 in 2017. By 2030, we are estimating that we’ll be performing 1,250 or more total joint replacements annually in Aitkin and Crosby.”

Dr. Severson added: “Understanding the future of joint care was an integral part of my orthopaedic surgery training at the University of Utah. This knowledge was further enhanced during my fellowship training in hip and knee reconstruction and joint replacement surgery at the Mayo Clinic.”

To meet the growing demand for orthopaedic care and joint replacements, MCO has expanded its provider team from two orthopaedic surgeons and one physician assistant in 2010 to three orthopaedic surgeons, a family physician, two physician assistants, two nurse practitioners and a full-time registered nurse in 2018.

The MCO team led by Dr. Severson includes orthopaedic surgeons Dr. Jon Herseth, fellowship trained in sports medicine, and Dr. Susan Moen, fellowship trained in hand, wrist and elbow; Dr. Austin Krohn, a family physician fellowship trained in musculoskeletal medicine; two physician assistants Matt Fleming and Tom Lewandowski; and two nurse practitioners, Adam English at Cuyuna Regional Medical Center and Josh Jacobson at Riverwood Healthcare Center; and Brianna Brophy, RN, joints coordinator, in Aitkin.

National exposure for local expertise

Within the past year, MCO clinicians presented high-level research on joint care treatment at three professional conferences across the country. These presentations were all focused on sharing expertise to improve patient outcomes in knee and hip replacement.

In June 2017, Dr. Erik Severson, gave a presentation and was a member on an expert panel discussion at the annual Anterior Hip Foundation conference in Las Vegas, Nevada. He discussed the outcomes in patients who had hip replacement from the “posterior” or back approach, compared to patients that had hip replacement from the “anterior” or front approach.

In October 2017, Board-certified Nurse Practitioners Adam English and Thia Carlson presented at the National Conference for Nurse Practitioners in Las Vegas, where over 1,000 nurse practitioners from across the country attended. They discussed outcomes in patients who underwent knee and hip replacement with interventions aimed at decreasing postoperative pain and narcotic consumption, length of hospital stay, complications, ER visits, and readmissions to the hospital.

“This conference provided an excellent platform to demonstrate that small, rural hospitals can have outcomes that are as good, if not better, than that of the larger institutions that provide joint replacement,” English said.  “Our MCO team is leading the way for best practices for joint replacement outcomes with our Rapid Recovery pain management protocols.”

With MCO’s Rapid Recovery protocol, a comprehensive pain management approach is used before, during and after joint replacement surgery. Before surgery, medications are given to help reduce pain while in surgery. During surgery, the surgeon and anesthesiologists use a combination of anesthetics and pain medication to keep the patient comfortable throughout the operation. After surgery in the recovery phase, the nurses are authorized to use a variety of interventions to ease the pain. The end result is that many patients are able to go home one day after joint replacement surgery.

In March 2018, Tom Lewandowski presented research findings in a poster session on excellent outcomes for patients undergoing total knee replacement revisions at the 2018 Annual American Academy of Orthopaedic Surgeons (AAOS) conference in New Orleans. The research article authors included English, Fleming, Lewandowski and Severson.

“We are always looking at the latest evidence and research to bring the best surgical experience to our orthopaedic patients,” Lewandowski said. “The goal of everyone involved in care is to keep patients comfortable after surgery while still allowing them to take part in prescribed physical therapy.”

For an appointment for orthopaedic care at Riverwood’s specialty clinic in Aitkin, call (218) 927-5566.