Orthopedic surgeon finds his home in the mountains with mountain people
PAINTSVILLE Eric Dennis, MD, orthopedic surgeon at Appalachian Regional Healthcare in Paintsville, Kentucky, played football and lacrosse at Chantilly High School, a northern Virginia suburb, about 25 miles west of the Washington DC metro. When Dennis grew up in Chantilly, it was a rural community, but suburban sprawl from DC is starting to take over.
Dennis was at Virginia Tech in Blacksburg, Virginia, studying to be a civil engineer when he tore his Achilles tendon playing flag football. He started shadowing William Hazel, MD, the orthopedist who did his surgery. Hazel went on to become the secretary of health and human resources for the Commonwealth of Virginia. After being exposed to the engineering mechanics of orthopedic surgery, Dennis pivoted to medicine, graduating with a degree in civil engineering from Virginia Polytechnic Institute and State University.
Dennis received his medical degree from the Medical College of Virginia at Virginia Commonwealth University in Richmond, followed by a fellowship in sports medicine at Wake Forest University School of Medicine.
In his third and fourth years of medical school at Fairfax County Hospital in Fairfax, Virginia, Dennis worked alongside the orthopedic trauma unit and became immersed in the field. He recalls, “That’s all the orthopedic trauma team did, severe fractures and pelvic fractures and real bad open fractures. They did fracture care all day, every day.”
Dennis did his internship and residency in orthopedic surgery at Marshall University in Huntington, West Virginia. In 2021 he joined Saint Claire Healthcare in Morehead, Kentucky, for three years. His wife Nicole’s best friend lived in Paintsville, and when the opportunity to join ARH in 2024 was presented, it was an easy decision.
He recalls, “I had always heard great things about ARH and it was the perfect situation to come down here. We’ve been here nine months now, and it’s been a great. We want to be here long term.”
Dennis met his wife Nicole at Cabell County Hospital where she was a hospital social worker. Nicole has since received her master’s degree in counseling. The surrounding outdoors and mountains of Eastern Kentucky suit the couple fine. “We’re right in the mountains here and everywhere you look, there’s beautiful trees and really nice places to walk outside. It’s like the best of both worlds,” says Dennis.
The Rural Orthopedic Patient Population
Being a smaller hospital in a rural area, Dennis says that he is a general orthopedist, typically in clinic three days a week and in the operating room two days a week. Patients range in age from the very young to very old with a variety of procedures, such as arthroscopy for rotator cuff tears and ACL tear sports medicine, total joint repairs, fractures, and nerve procedures such as carpal and cubital tunnel. “I really like general orthopedics because every day is different, dealing with what comes through the door,” says Dennis.
“I do total knees, total hips, and total shoulders, which is what an upper extremity or sports guy would do. When I do hip replacement, I use the anterior approach because recovery is a little quicker than from the posterior approach. In training we did at least 80% anterior approach,” says Dennis. The patients fall into three groups, says Dennis. There’s the younger people who are sports medicine patients; there’s the middle-aged group who are there for arthroscopic tendon, ligament, or cartilage repair; and then the older patients who come for total joint replacement.
“There’s one aspect about the people here, compared to where I grew up. Not to knock the people from Northern Virginia, but I love the people from Appalachia. I feel like they’re all easy going. People are very nice to be around; they listen and do what they’re supposed to. What I want them to do is to get better and recover. It’s just a great patient population,” says Dennis.
In addition to his hospital based clinical practice and surgery, Dennis will be covering Paintsville High School sport teams, starting with football this fall.
He states, “I did a sports medicine fellowship, so that’s something that I do enjoy covering. I like taking care of the athletes, they’re a great patient population because they’re so motivated to get back to playing sports. They’re the ones you have to slow down and tell them, ‘Hey, you got to go a little slower. We want you to get better before getting back on the field.’”
Getting Comorbidities under Control
Except for fractures and orthopedic trauma patients, most of Dennis’ patient’s surgeries are elective. Patients can modify some of the factors needed to have surgery for total joints and invasive surgeries. Dennis notes that sometimes that gives patients a motivation to quit smoking, lose weight, or get their blood glucose at the proper level. He recalls, “I’ve had a number of patients who have given up smoking so they can have their total joint surgery and then haven’t picked it back up afterwards. Or they get their diabetes and BMI under control, because we have specific cutoffs. We know that if a patient is over a certain cutoff with their glucose levels, like over 7 and a BMI over 40, that they’re at much higher risk for infection after a procedure.”
“In general, we can help make people more mobile and actually get healthier after surgery,” says Dennis.
When asked if he’s conservative or aggressive with his patients considering surgery, Dennis says, “I’m right in the middle area for taking people to surgery. I say to people that as much as I like operating, it’s better off for you if you can get better without surgery. In orthopedics, we’re not doing something that’s going to save your life, it’s going to be something to enhance your quality of life.”
In rural settings, many referrals come from family members of patients that Dennis has already treated. “I do get that a lot.”
Advancement in Orthopedic Surgery
When Dennis did his fellowship in sports medicine, he learned techniques for perfecting the way tunnels are drilled for ACL tears that result in a more stable ACL with a lower chance of re-rupture. The same occurred with rotator cuff repair. “We’ve advanced to where we do most of them arthroscopically, and the re-injury rates have gone down,” he says.
Similar progress has been made in total joint repair, says Dennis. “We’re already seeing a game changer in robotic total joint arthroplasty. I think that they’re going to progress robotics to other parts of orthopedic surgery in addition to total joints.”
Getting a robotic surgical system to the ARH hospital in Paintsville is on Dennis’ to-do list. “I’ve already been talking with the administration here, and some of the implant companies about potentially getting a robot here. It helps us put the implants in more perfectly and helps patients recover a little faster, because it’s done with a little less soft tissue dissection and it’s a little less traumatic,” says Dennis.
The potential patient for total joint replacement has changed somewhat too. Dennis recalls two different patients, a man in his 80s who had a severe arthritis but felt he was too old for new knees, but otherwise very healthy. “I always tell people, ‘Age is just a number. It’s more about your health and your ability to recover and rehab and the motivation you have.’ The man had the knee surgery and was up walking around the day after surgery,” says Dennis.
Dennis also recalls a female patient in her 60s with extreme bursitis on the side of her hip. She had gone the route of multiple injections without substantial relief and finally decided on surgery. “I just saw her at her first two-week visit, and she’s like, ‘Can I give you a hug? Because this is the first time I haven’t had the pain in years, and I’m just ecstatic,’” says Dennis.
What’s the Problem To Be Solved?
“My main motivation is helping people get back to being where they want to be. My undergrad degree was civil engineering, and essentially, it’s a problem-solving mentality. I feel like orthopedics allows me to do that same problem-solving, but with people. Help them solve their problems to get them back to being where they want to be. I’ve always loved the problem-solving aspect of anything in life, and orthopedics allows me to do that firsthand with people, and in a way that I get to use my hands to help them,” says Dennis. And that’s what problem solvers do.