40 Years of Growth, Advancements Pay Off for Orthopaedics at LMC

In 1979, Lexington Medical Center went looking to hire an orthopaedic surgeon as it planned to move to its new campus on Hospital Drive. Meanwhile, a young orthopaedic surgeon in Knoxville, Tennessee, began looking for a town where he could build a practice.

The medical center and the surgeon found each other. Forty years later, the partnership has spawned a thriving orthopaedic service at Wake Forest Baptist Health Lexington Medical Center.

“It was interesting. We had a small office initially,” says Karl Bolstad, MD, who became Lexington’s first board-certified orthopaedic surgeon and now is one of four such surgeons at the medical center. “I started off with just an x-ray technician, a nurse and one clerical person, and it gradually kept growing.”

For nine years, Bolstad worked alone, on-call constantly aside from one day a week, one weekend a month and an occasional vacation.

“Back then, I could have the residents from Wake Forest Baptist cover for me, which is how I got to know Dr. (Gordon) Kammire,” he says. “It worked out well that he came and worked with me on almost a trial basis while his wife was finishing up her Ob-Gyn residency.”

Kammire chose to stay in Lexington in 1988, and since then, the service has added physicians Sims Riggan, MD, and Amanda Shepherd, MD. The service also has expanded its reach by working with groups such as Robert Humble, MD, and Jordan Case, MD, at Orthopaedic Associates—Salisbury.

Through the years, enhancements in orthopaedic care at Lexington Medical Center have included physical therapy, arthroscopic surgery, joint replacements and the use of fluoroscopy, which allows surgeons to use imaging to repair broken bones without having to open the fracture site. Tendon and ligament surgeries that once required long, painful recoveries now are much easier for patients, and joint replacements have become common.

“We don’t talk to people anymore about a 10-year joint, we talk about 30 years or a lifetime,” Bolstad says. “If somebody is 60 years old, their knee replacement is probably going to last the rest of their life. That’s been a big plus.”

One of the department’s strengths is its Joint Replacement Center, which opened in 2007.

“We wanted to separate our joint replacement surgery patients from others in the hospital to try to isolate them from infection on the regular patient unit,” Bolstad says.

The idea has paid off. There are very few complications with surgeries at the center, which was first certified for its hip and knee programs in 2012 by The Joint Commission, the nation’s top accrediting body for health-care quality, and recertified every two years since.

Immediately following a hip, knee or shoulder replacement surgery, patients go directly to what’s called “Joint Camp.” There, inpatient care begins right after surgery and patients receive individual attention from doctors, nurses and therapists. They do group therapy with up to four other patients who are recovering from similar surgeries, regaining mobility and learning rehabilitation exercises they will do for months after they leave.

The group experience creates “a little camaraderie, a little collegiality and maybe even some subtle competition,” Kammire says. A staff of nurses works exclusively with the unit and stays attuned to patient needs, and care is standardized based on best practices shared among medical professionals across the country.

“We have a set of nurses and CNAs dedicated to the unit, so patients are receiving the same information consistently from all the staff members,” says C.J. Miller, RN, the Joint Replacement Center’s lead orthopaedic nurse.

Miller also teaches a class for patients who are scheduled for joint replacement surgery to help them understand how to prepare for the surgery and review what will occur while in the hospital.

“The class seems to ease their apprehension a bit,” Miller says. She adds that the whole experience at the center is designed to give patients and their families the confidence they need to care for themselves after hospitalization.

Orthopaedics patients will be among those who will benefit from a new surgical facility under construction at Lexington Medical Center. The $31.5 million project, aided by a $3 million community fundraising campaign, will provide new operating rooms to replace those in use since 1979.

“It’s like I tell our patients, ‘Would you want to drive a 40-year-old car?’” Kammire says. “That’s essentially what we’re doing with our current operating rooms. They have served us very well, but they are 40 years old. We’re excited about having a new surgical facility.”

In addition to providing the full range of orthopaedic services, Kammire estimates the department is on pace for over 400 joint replacements this year.

“We take care of patients in a personal way,” he says. “We sit down and talk with them. We see them from pre-op through post-op. We give a lot of individual attention that I think we’re better able to do in a community setting like ours.

“People don’t want to travel out of town to other places to receive care if they don’t have to, and in most cases, they shouldn’t have to. Even though we’re in a relatively small town, we’re able to deliver first-class care.”

To learn more about our expert Orthopaedic services visit WakeHealth.edu/Orthopaedics or call 336-249-2978. Same-day and next-day appointments are often available.