Lower extremity total joint arthroplasty (TJA) volumes at Dartmouth Hitchcock Medical Center (DHMC) have increased steadily over the past decade, with particular growth in revision joint replacement.
The DHMC Orthopaedics’ Hip and Knee Arthroplasty Division boasts a core faculty with national prominence and a clinical practice that performs high volumes of primary and complex revision hip and knee arthroplasty, with an emphasis on direct anterior hip replacement that is becoming the new standard of care. This unique environment, coupled with the academic opportunities presented by Thayer’s Biomedical Engineering Center and the Dartmouth Orthopaedic Registry, provides the critical elements to establish a top-tier adult reconstruction fellowship that will improve the training appropriateness of our residents’ experience and yield highly trained, judicious arthroplasty surgeons who will meet the looming arthroplasty needs of our aging population. .
The Adult Reconstructive Surgery Division at DHMC seeks to train our Fellows to independently perform primary hip and knee arthroplasty and complex revision procedures.
Arthroplasty Fellows will participate actively in a high-volume TJA practice with a strong emphasis on the direct anterior approach for primary total hip arthroplasty, complex hip and knee revision surgery, arthroplasty-related trauma—including peri-prosthetic fractures and infections—and practice management duties to aid in her or his transition into practice.
Arthroplasty Fellows will:
- Participate actively—commensurate with their intended professional goals of a career adult reconstruction—in the clinical and surgical management of patients with advanced degenerative hip and knee problems, with a focus on failed arthroplasties.
- Be expected to have a minimum of two research projects suitable for publication/presentation by completion of the fellowship.
- Have the opportunity to engage with the Thayer Biomedical Retrieval Lab.
- Be board-eligible, credentialed as faculty, and be expected to transition into a junior attending role during their fellowship year, taking on increasing independence.
- During call, be expected to mentor residents in their role as junior faculty.
- Take general trauma (two weeknights/month, four weekends/year, and one holiday at minimum).
- Have the opportunity to cover the trauma room and manage basic fractures if they desire.
- May scrub megaprosthesis cases on the tumor service.
- May get credentialed and participate in arthroplasty cases at DHMC members.
- Must demonstrate proficiency in primary and complex revision TJA upon graduation.
- Will have the opportunity to run a solo arthroplasty clinic with attending oversight.
Joining a new fellowship carries risks that an established program may not, however with the right leadership in a hospitable environment it can be a great experience. I decided to join the Dartmouth arthroplasty fellowship after extensively investigating the departments' reputation. Dr. Moschetti and his team of colleagues demonstrated a truly collegial working environment and were fully invested in my professional development. The high case volume allowed me to be easily integrated into the arthroplasty team without having to squabble over cases with residents. Despite the COVID19 pandemic, I completed 425 cases with 35% being revisions. Being licensed as a junior faculty member allowed me to take on additional clinical responsibilities, run my own clinic, cover the trauma room at a level I trauma center, and develop my own intraoperative leadership style. Although my current career plans are non-academic, with the help of the departments' stellar research staff I was able to complete 4 research projects and help secure grant funding for an upcoming randomized control trial. I would very strongly recommend this fellowship to any applicant who is interested in a hands-on transition-to-practice arthroplasty fellowship with an emphasis on revision surgery and anterior approach total hip arthroplasty.David Christensen, MD
Former Arthroplasty Fellow