Mammoth Orthopedic Institute: From Clinic to Institution

From Left: Orthopedic Surgeons, Timothy Crall, MD, Stephen Knecht, MD, Brian Gilmer, MD, and Michael Karch, MD

From the creation of Mammoth Hospital in 1978, our orthopedic practice has come a long way. That same year, Dr. Wade Eckert, a local orthopedic surgeon who started Alpine Medical Clinic in Mammoth began providing orthopedic services and surgeries for Mammoth Hospital. A couple of years later, Dr. Tom Smith and Dr. John Hays established local full time Orthopedic care for Mammoth Hospital over the next decade. This era saw orthopedist, Dr. James Cole joining the group as well.

Dr. Smith was instrumental in establishing an outreach program to service communities such as Bishop, Big Pine, Lone Pine and Ridgecrest, offering orthopedic services and utilization of our hospital over this time. After Dr. Cole and Dr. Smith’s departures, Mammoth Hospital was without a full-time local orthopedist, but provided orthopedic care with a rotating roster from visiting orthopedists based in San Diego.

This changed with the permanent recruitment of Dr. John “Jack” Perry in 2001 and later Dr. Michael Karch in 2003. These two permanent surgeons formed the core of what would later become Mammoth Orthopedic Institute. Over the next 20 years, this practice has grown to include four local full-time surgeons, three part-time surgeons, four Physician Assistants and a multitude of supportive staff, covering six distinct orthopedic subspecialty areas.

Dr. John “Jack” Perry in the early days.

The story of our growth really begins with Dr. Karch as a founding member. Dr. Karch, who completed his residency training at Georgetown University Medical Center in Washington, D.C. and Fellowship training at the Taos Orthopedic Institute in Taos, New Mexico, provided high quality care and was instrumental in integrating with the local community and positioning Mammoth Orthopedic Institute to become a trusted ally not only in the immediate community but in the entirety of the Eastern Sierra region. Dr. Karch built on existing town and hospital relations by founding the Mammoth Winter Biathlon and co-founding Mammoth Medical Missions, 501c3 as well as the International Disaster Medical Conference. All three concepts as well as his work in foreign disaster and conflict zones brought national and international recognition to both the hospital and town of Mammoth Lakes.

Dr. Michael Karch with wife, Dr. Kim Escudero in 2007.

After a few years, it became apparent that despite his dynamic energy and expansive personality, Dr. Karch would not be able to carry the torch alone. Subsequently, in 2011, he recruited Dr. Timothy Crall, a highly skilled surgeon trained at Harvard Orthopedic Combined Residency Program who also received Fellowship training at the Taos Orthopedic Institute. Upon his arrival, Dr. Crall showed tremendous skill and proficiency in the management of shoulder injuries and this quickly became his area of sub specialization. Dr. Crall now routinely performs complex shoulder reconstruction both arthroscopically and when necessary, with shoulder arthroplasty (joint replacement). Additionally, he cares for many complex fractures which can occur around the shoulder. Dr. Crall is a hospital leader and past Mammoth Hospital Chief of Staff. He serves as an editor for the Arthroscopy Journal acts as the Medical Director of all Mammoth Mountain team sports.

Because of this early success, the need to further expand became apparent and Dr. Brian Gilmer was recruited. After completing his Fellowship at the Taos Orthopedic Institute, which had been proven as a reliable training ground for highly skilled and caring surgeons working in mountain communities, Dr. Gilmer joined the Mammoth Orthopaedic Institute Team in 2014.

Following the lead of his predecessors, Dr. Gilmer, who completed his residency at the University of Washington, further endeavored to develop specialized skills in treating sports related knee injuries. Dr. Gilmer specializes in sports related injuries to the knee and shoulder and he developed his own nationally recognized niche performing complex reconstructions of severely injured knees with multi-ligamentous problems as well as injuries of the cartilage and meniscus. Dr. Gilmer serves as an industry consultant for Arthex, Inc, a leader in sports medicine implants and routinely writes and edits for internationally recognized journals in his chosen sub-specialty field. He provides cutting-edge and novel approaches to the complex injury patterns seen with mountain-based athletes, allowing more patients to return to work in the activities they love in our mountain environment.

A new building for Orthopedics and Physical Therapy was constructed in 2005.

Finally, and most recently, based on the demands of our community and growing reputation, the orthopedic group saw a need to expand yet again. In 2019, Dr. Stephen Knecht was recruited from a 15-year practice in Flagstaff, Arizona for his expertise in both lower extremity trauma and foot and ankle surgery. Dr. Knecht completed his orthopaedic residency at the University of Iowa and Fellowships at Royal North Shore Hospital in Sydney, Australia and Auckland Hospital, in Auckland, New Zealand. He is the only surgeon at the Mammoth Orthopedic Institute with dual fellowship training in both foot and ankle and trauma surgery. Known for his calm demeanor when faced with complex trauma, Dr. Knecht joins the rest of our providers in routinely traveling with and covering international World Cup events with the U.S. Ski and Snowboard Teams.

With Dr. Karch having shifted his practice exclusively to state-of-the-art Adult Reconstruction performing computer navigated anterior total hip and knee replacements, and Drs. Crall, Gilmer and Knecht moving towards further sub-specialization in their respective fields, it became apparent that a comprehensive, sub-specialty orthopaedic practice was required in order to adequately take care of the diverse injury patterns that occur in the Eastern Sierra.

Dr. Richard Brown, who completed his Residency at the University of Pennsylvania and Fellowship at Harvard, started with the Mammoth group is 2006 and is internationally recognized as a specialty hand surgeon. Dr. Brown lectures and teaches internationally on various topic related to hand surgery. He brought with him Drs. David Hackley in 2007 and Richard Thunder in 2011. Dr Hackley, who completed his residency at the Georgetown University Medical Center, has an extensive background treating sports related trauma in the United States Navy and covers many local sports teams in the state of California. Dr. Thunder completed his Orthopaedic Residency and Fellowship training at Stanford University in spine surgery. Both physicians routinely operate at Mammoth Hospital.

Dr. Brian Gilmer consults with a patient.

To expand upon our team-based approach to care for the whole person, Physician Assistants were added. These providers work in close coordination with the surgeons and train with the same level of clinical skill and acumen. The addition of Physician Assistants expanded our orthopedic team and allowed patients better access to early care by developing better treatment plans and directing more focused rehabilitation. Today, a total of four physician assistants, including Bartlett White (2011), Karly Dawson (2012), Brittania Cogan (2017), and Chelsea Brown (2019), effectively double the capabilities of our team.

As part of our continual growth, outreach was extended to athletes in both the Mammoth High School and Mountain programs by hiring certified athletic trainers. The Mammoth Orthopedic team was able to provide coverage to our local teams and athletes on the field and on the slopes. Today, our team of four athletic trainers, Michael McMahon (2013), Sarah Lang (2016), Zachary Smitheman (2016), and Parker McKinney (2019), provide coverage, education and rehabilitation to our local athletes as well as supporting our clinical needs in the physician practice setting. Katie Dease (2003) Orthopedic Technologist, EMT and Radiologic Technologist, Kelli Wagner (2017) EMT and Orthopedic Technologists, and Heather Roberts (2020) CNA round out our supportive clinical staff and are experts in wound care as well as cast and brace management.

Treatment plans and even surgical procedures are only as good as the postoperative rehabilitation and recovery that followed them. The world-class team of physical and occupational therapists at Mammoth Hospital represent some of the finest men and women in their field. Through their own personal endeavors and interests as well as their professional development, they have developed a unique ability to understand athletes and treat the whole person to ensure the best outcomes and recoveries. They are closely integrated and enjoy unique working relationships with our clinical care teams that ensure a smooth transition of care for patients and clear guidelines for rehabilitation and recovery.

In addition to training medical students attending the University of Nevada, Reno School of Medicine, Mammoth Orthopedic Institute has recently collaborated with the Lake Tahoe Sports Medicine Fellowship in South Lake Tahoe, California. Starting in 2020, the Mammoth Orthopedic Institute physicians have begun training licensed surgeons who have completed a United States Accredited Orthopaedic Residency Program and are seeking further subspecialty training in the field of Orthopaedic Sports Medicine. These highly skilled and capable physicians enjoy the opportunity of unique learning and intense surgical training under the guidance of our staff surgeons. The addition of training programs under Mammoth Orthopedic Institute with the support of Mammoth Hospital creates a legacy of care and expands our reputation beyond our regional borders to the rest of the country as these trainees move on to represent us in their future careers. This reflects well upon not just our healthcare community but the Mammoth Lakes community. This fellowship training, in addition to the nationally recognized annual Mammoth Sports Course, which attracts surgeons from around the country to discuss complex care and the treatment of high demand athletes, adds to the ever-growing academic and clinical research climate that is occurring at Mammoth Hospital.

Today, the Mammoth Orthopedic Institute looks vastly different than it did with its’ humble origins in 2001. This sub-specialty orthopedic team and ancillary services have developed broad reach, an admirable reputation and provide excellent care, academic teaching, and published research in the field of orthopedic surgery. This highly skilled team of dedicated individuals are here to serve the Eastern Sierra and communities beyond.