Dear Editor,

RE:    A COA Member's Journey through Orthopaedics and the Manitoba Provincial Election, May 23, 2007 (Ed - Bulletin #78, Fall 2007, pg. 14-15)

A number of exciting initiatives exist in orthopaedic surgery in Manitoba with developments over the last couple of years.

Arthroplasty waitlists have declined with concentrated effort to improve efficiency. This has been a combination of increased volume and improved physician efficiencies through the use of clinical assistants. This has enabled physicians to operate at the Concordia Hospital under an arthroplasty specialized setup using double operating rooms. The Arthroplasty Group in Manitoba have been leaders in the National Joint Registry, as well as the National Standards Committee. The group is also successfully endeavoring to improve their arthroplasty centre further by building an Arthroplasty Institute, including dedicated research and lab space.

The Pan Am Sports Medicine Centre was purchased in 2001 by the provincial government and the overall provincial investment with four expansions in the last five years, has been over twenty-five million dollars. Currently, the centre offers five physicians, as well as physiotherapy, athletic therapy, a state-of-the-art diagnostics, including MRI, casting and other services. It also is the centre for plastic surgery, including hand surgery, a pain clinic, a prehab unit for arthroplasty care, as well as a minor injury clinic for musculoskeletal emergencies, which is opened approximately twelve hours a day. Recently, a paediatric minor injury clinic has extended that concept to paediatrics minor musculoskeletal injuries. The Pan Am Foundation has raised three million dollars for a dedicated biomechanics skills lab, which is currently under construction.

It has been a model of efficiency and high levels of care for other centres around the country with 200,000 patient visits per year.

The two major community hospitals delivering orthopaedic surgery are on the verge of combining their services for trauma and elective work, which will see a combined call schedule and collaborative effort in terms of elective time and call. This will improve lifestyle for the two busiest community orthopaedic centres.

The state of orthopaedic surgery has improved in terms of its management with both a medical and non-medical manager at the WRHA level. Orthopaedics is governed through the Winnipeg Orthopaedic Surgery Executive, which consists of heads of the orthopaedic sections in all centres. This acts as an advisory group to the Winnipeg Regional Health Authority.

Spine and trauma work is currently being delivered at the Health Sciences Centre. The spine service is combined with neurosurgery and is delivering high level state-of-the-art spine care and offering a fellowship in that area. A Spine Research Programme has also been fostered and continues to grow focusing on motion analysis and accelerometry.

Trauma care at the Health Sciences Centre has been improved with the addition of four full time trauma surgeons with daytime trauma rooms five days a week at the major tertiary trauma centre. Clinical fellowship training is being developed in trauma surgery to complement sports, arthroplasty and spine fellowships.

The Manitoba Orthopaedic Society remains a unifying force in orthopaedics dealing with fee issues, Workers Compensation issues and sponsoring the annual Manitoba Orthopaedic Symposium. It also sponsors special social events, an outlet for surgeons and their wives as well as a Visiting Professor Programme.

All these initiatives have improved orthopaedic care within the province of Manitoba. We look forward to other initiatives to continue to progress to an efficient model of care.

Yours sincerely,

Peter B. MacDonald, M.D., FRCSC
Professor and Head, Section of Orthopaedic Surgery,
University of Manitoba
Regional Leader, Section of Orthopaedic Surgery, WRHA

Warren Froese, M.,D, FRCSC
President, Manitoba Orthopaedic Society