Nick the Knee MD

Nick the Knee MD Complex knee surgeon in the PNW. Mayo Clinic graduate. Professor at CWU, WSU, & PNWU.

Had the privilege of being faculty at the recent in Phoenix with the amazing folks at . OSSIO is an innovative company...
05/11/2026

Had the privilege of being faculty at the recent in Phoenix with the amazing folks at . OSSIO is an innovative company focused on metal free implants that are designed to become “one with your bone” over 18/24 months (future post explaining the technology incoming. Always equal parts fun and educational to interact with colleagues ( and others) and share ideas and techniques focused on tackling tough clinical problems and improving patient outcomes. Also, as always had to check out the local coffee scene, loved great vibe even better coffee! Special thanks to for coming with and being my chaperone!
As a patient would you prefer metal or more biological implants for your surgery?

04/10/2026

All new medicine movie mashup.
When undergoing a surgical procedure you can have it performed at either a hospital or an outpatient “ambulatory” surgery center. Both have benefits. The advantages of an ASC (ambulatory surgery center) is often the process is more streamlined, there are less people, patients etc present so your overall surgery day is much more efficient. There can also be advantages when it comes to cost and infection rates at an ASC. Where your surgery is performed really comes down to the type of procedure you are having and the health of the patient. One procedure that is appropriate for an ASC is knee arthroplasty or a knee replacement. In Yakima at our newly renovated ASC(shoutout modernstructures for the work), we were very proud to be the first ambulatory surgery center in the MultiCare network to perform a total knee replacement. However, apparently my dad beat me to the punch on first outpatient knee arthroplasty in Yakima!
If you ain’t first you are last.

04/03/2026

It doesn’t matter what your chosen profession, no one likes excessive paperwork. Unfortunately the field of medicine, particularly with current state of big hospital systems and the complexities of modern health insurance is not immune to the inconveniences of stacks of paper leading to carpal tunnel and writers cramp. Fortunately, like most aspects of healthcare all tasks are split up and tackled with a team based approach. I am fortunate to have a great team consisting of Britt, Kent and Margarita to help lessen the load. However, occasionally there is a nice large stack of papers that require my Herbie Hancock, and that is a sight that elicites a fear only Brad Pitt in Seven could understand.

As always produced by the insanely talented .ricard.dp

03/28/2026

Time for the second edition of Super Hero Stories! The goal of these stories is to highlight amazing accomplishments of our patients and to emphasize that an injury does not need to be the end of your athletic careers. It can instead just be a minor speed bump on your super hero journey.

Our featured patient of the week is Colton Magruder, an amazing multi-sport athlete who sustained a knee injury during a football game as a junior in high school. He underwent surgery and a long arduous recovery process, working his tail off and staying consistent with his rehab and workouts.

Spoiler alert: the hard work paid off. He returned better than ever and was not only a two-time state champion sprinter (100/200), but he had one of the fastest 60m times in the country this year at Central Washington University and was a Second Team All-American as a freshman!

We are proud of Colton and I am blessed to have been a small part in his journey! Can’t wait to see what you do next!

03/18/2026

Y’all already know what time it is 👀 Medicine Movie Mashuppppps!

Medicine, like other fields of science and technology, is in a constant state of evolution. Every year, there are new techniques and products which help physicians to provide even more accurate, precise and customized care for our patients. One piece of technology that’s incredibly valuable is Arvis Astra by Envois. This technology is augmented reality, which I wear on my head, and get a heads-up display just like Tom Cruise in Too Gun. The data displayed allows me to make precise decisions at the time of surgery that allow me to customize each surgical experience to the individual patients specific needs.

I am beyond grateful excited that this is what the future of technology in the OR looks like, and what it will allow us to do for our patients to help the get back to the activities they love in life, pain free!

By the way, I’m not sponsored by Envois. I’m just a fan girl for their products.

🎥: Blades of Glory
⭐️:
🎦: edited & produced by .ricard.dp

medical humor, blades of glory, movie mashups

03/06/2026

Medicine Movie Mashups is back!

Believe it or not, more than 50% of people actually have “crooked” lower extremity alignment. The majority of us are either bow legged (genu varus) or knock-kneed (genu valgus). Often times, the “deformity” or crookedness is severe enough that it leads to overloading on one side of your knee, causing pain and eventually knee breakdown or osteoarthritis.

The good news for all us crooked folk? There are numerous surgical as well as non-operative options. One of non-operative options we often utilize is unloader braces. These braces act like a car jack to open up the space on one side of your knee, relieving pressure and pain. Many of the newer designs — including those available with Ossur — even have functions that can protect ligament and “unload” your knee at the same time, and they are lightweight enough to be used for return to sporting activities!

And to the 32% of you who guessed Forrest Gump correctly in our poll… any guesses on what next week’s will be? 👀

🎥: Forrest Gump
⭐️:
🎦: edited & produced by .ricard.dp

This last month has been a whirlwind of travel, teaching, learning and amazing opportunities to connect with colleagues ...
02/11/2026

This last month has been a whirlwind of travel, teaching, learning and amazing opportunities to connect with colleagues and friends! It started with a trip to Austin to visit my friends at Enovis and discuss what’s coming soon in the world of augmented reality in surgery.

Then it was a quick trip to Nashville to talk all things unloader bracing with the amazing folks at Ossur.

Straight from Nashville, I headed to Minneapolis to teach a Smith & Nephew Fellows Course with some of my amazing mentors and friends like , , , Chris Larson, and Chris LaPrade.

The week after that, I found myself on the east coast discussing all that’s new in the world of cartilage restoration with the esteemed Vericel team.

I rounded out the month back with the likes of and in Nashville.

Always appreciate the opportunity to learn from those brighter than me, and getting to do it in some cool cities is a plus!

01/24/2026

🎥: Wedding Crashers
⭐️:
🎦: produced by

Moooovie mashup time!

This time, we have my favorite scene from my favorite movie, Wedding Crashers. Ever wondered who keeps us orthopedic surgeons in line? That would be our medical assistants. They have the near impossible task of keeping us on-task and on-time. Which, given how much most surgeons love to hear themselves talk, can be quite difficult. From dealing with return to work forms, answering patient phone calls, helping deal with and sometimes fight the insurance companies, medical assistants wear a lot of hats and have very demanding jobs. Fortunately we have who helps keep Kent, Britt and myself in line.

Also a shoutout to another fantastic rep for playing the Owen Wilson role in this video and helping talk about . It’s a great technology that helps my patients work on early range of motion after surgery which is key to success.

01/17/2026

Medicine Movie Mashups is quickly becoming Adam Sandler Movie Medicine Mashups. Not mad about it.

While golfers have caddies as their loyal companions, orthopedic surgeons have device reps. Instead of helping select the correct club for distance and course conditions, the rep’s role is to ensure the physician has the correct tools, knows how they work and ensures they are used correctly. Sometimes — like the faithful caddy — the reps find themselves at the mercy of the emotions/mood of the surgeon.

However, I can’t overstate how invaluable they are to the success of the procedure and therefore good patient outcomes. I’m very fortunate to work with a fantastic group of device reps:

Big thanks to Bruce for always being a good sport and lending his acting prowess to this video. I promise I don’t actually call him names!

As always thanks to Kent, my partner in crime .

As always, produced by .

Inspired by the great Adam Sandler in Happy Gilmore. Adam, holler if you ever want to collab on one of these someday 👀

🎥: Happy Gilmore
⭐️:
🎦: edited by

01/09/2026

Happy Gilmore 🤝 Nick The Knee MD

“Am I gonna have an ugly scar?” is one of the most common questions and concerns for patients. The aesthetic appearance of the scar is primarily determined by two factors.

1) The first and more important is your biology. Healthy habits, avoiding ni****ne, eating a healthy diet with sufficient protein, fruits and vegetables, and your personal genetics. Some people are prone to forming big keloid scars, and unfortunately no matter how healthy they are, that’s how their scar will form.

2) The second important aspect of your scar is the skill and care of the person “closing” (suturing) your skin. In many/the majority of orthopedic ORs in the country, that responsibility lies with the nurse practitioner/PA/surgical assist. Fortunately for our patients, they get the expert skills of Britt The Knee NP.

Don’t take the skit too seriously — it’s just for show. We really aren’t that hard on Britt… right ?

🎥: Happy Gilmore
⭐️:
🎦: edited by

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2811 Tieton Drive
Yakima, WA
98902

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