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Dr. Rick Cunningham

Speciality: ACL Reconstruction, sports injuries to knee and shoulder, partial and total knee replacement, Orthopedic Trauma
Assistant: Matt Cain, PA-C

Some of the latest breakthroughs in orthopedics have come from questioning the very things that are questioned the least: like where to attach ACL grafts. Until recently, it was considered standard protocol to attach ACL grafts in the same place for all patients regardless of where the patient’s original ACL attachment may have been. Understanding that a 125-pound ballerina has very different anatomy from a 285-pound football player, Dr. Cunnningham followed the research on ACL grafts very closely. Dr. Cunningham now ascribes to the practice of attaching grafts at their original insertion points where the reproduction of native attachments ensures a better outcome.

Dr CunninghamDr. Cunningham is a full-service knee and shoulder specialist with particular expertise in ACL reconstruction, partial and total knee replacements and cartilage restoration surgery. He completed an optional knee and shoulder fellowship in Sports Medicine, knee surgery and shoulder surgery. A fellowship has been likened to gaining 10 years of clinical experience in a given subspecialty over one intense year.

When asked what makes for a good orthopaedist, Dr. Cunningham believes it requires skillful hands for surgery, good clinical judgment and being a good listener. The former is something you either have or you don’t, while the latter two take diligence and the ability to connect with patients on a personal level.

 
    US Ski Team Physician

Recognizing that no two patients are alike, Dr. Cunningham has mastered a wide variety of surgical procedures depending on the patient’s age, level of activity and other variables. This is evidenced by Dr. Cunningham’s approach to ACL reconstruction. Sometimes he’ll use a cadaver graft, sometimes a hamstring graft, and often a combination of two graft strands instead of one, which is the so-called “double-bundle” ACL reconstruction that only a handful of surgeons have done.


Triple Bypass Ride

Dr. Cunningham is excited about the latest advancements in cartilage restoration, specifically using implants (cadaver and autologous chongrocyte implants) in those patients who have lost their meniscus or articular cartilage as a result of an injury and surgery. As for partial and total knee replacements, he does more of these than any other orthopedic surgeon in Eagle and Summit counties. Be sure to watch his video workshop on joint replacement.

Sports have always played a big part in Dr. Cunningham’s life. He spent his childhood weekends ski racing in upstate New York. Rick skied competitively through college and now enjoys the sport with his wife Diane and their children. Cycling and running are his passion in warmer months.

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Education

UNDERGRADUATE

  • Amherst College, 1988

MEDICAL SCHOOL/TRAINING

  • University of Washington School of Medicine, 1997
  • Orthopedic Surgery Residency, University of Utah School of Medicine, 2002
  • Orthopedic Sports Medicine Fellowship, University of Pittsburgh Medical Center, 2003

BOARD CERTIFICATION

  • Diplomate: American Board of Orthopedic Surgery, 2005

Noteworthy

Affiliations

  • American Orthopedic Society for Sports Medicine
  • Arthroscopy Association of North America
  • American Academy of Orthopedic Surgeons, Fellow

Articles

  • Hamstring Tensioning in ACL Resonstruction
  • Gait Analysis and Biomechanics of Unicompartmental Arthroplasty of the Knee
  • Fixation of Proximal Humerus Fractures
  • Book Chapter on Shoulder Biomechanics

Appointments

  • Chief of Surgery, Vail Valley Medical Center, 2009 - present
  • Head Team Physician, Freedom FC Semi-Pro Soccer Club

In The News

Dr. Cunningham's Patient Stories

Maggie Silvers
Procedure: IT band surgery
33 year old Maggie Silvers was on a run in October 2009 when she felt a sharp, burning pain everytime she bent her knee. Learn More
Laura Landre-Girten
Procedure: Meniscus repair
Being an athlete my whole life, I felt pretty lucky that up until now I had not sustained a major injury that required surgery. Learn More
Taylor Seaton
Procedure: Torn meniscus repair
Skiing nearly 300 days a year as a 21 year old professional freestyle skier, Taylor Seaton has been through some tough skiing related injuries. Learn More
Jaime Brede
Procedure: Torn hamstring repair
I was horsing around with friends on the Fourth of July, when I performed a most ill-fated dance move not to be attempted by anything other than accomplished gymnasts, yogis, and the like. Learn More
Kym Rock
Procedure: Knee replacement surgery
Twenty-two broken bones, three concussions, three knee surgeries, a left rotator cuff surgery, two neck surgeries, plates with screws and a piece of my hip included. Learn More
Joe Schmitt
Procedure: Full Knee replacement
Vail Resorts Nordic Ski School Director reports another successful full knee replacement out having fun in the Backcountry. Learn More
Dave Zrubek
Procedure: ACL and medial meniscus repair
On Christmas Eve of 2009 I tore my ACL and damaged my medial meniscus while skiing at Vail. Learn More
Jeanne Nedrelow
Procedure: Knee replacement surgery
After living in Vail for 36 years and having an active lifestyle, Jeanne Nedrelow’s knee slowly started deteriorating. Learn More
Matt Norfleet
Procedure: Reconstructive knee surgery
In the summer of 2009, Matt Norfleet was guiding a group of whitewater rafters down a particularly treacherous stretch of the Colorado River's Gore Canyon called Tunnel Falls. Learn More
Greg Abernathy
Procedure: Knee replacement surgery
Greg Abernathy was told he needed a new knee 15 years ago. Learn More
Judd Santry
Procedure: Double bundle ACL reconstruction
Judd Santry says at first he didn't think much of it when his ski tips crossed and he went down. Learn More
Bill Suarez
Procedure: Total knee replacement
Having been a ski instructor for 30 years, Bill Suarez is no stranger to knee injury and knee pain. Learn More
Bethany McGee
Procedure: ACL Repair
At first, Bethany McGee thought she was fine after being hit by an out-of-control skier at Beaver Creek ski area. Learn More

Dr. Cunningham's Videos

Meniscus Repair with Dr. Rick Cunningham | VSOrtho

Meniscus Repair with Dr. Rick Cunningham

Meniscus Repair with Dr. Rick Cunningham of Vail Summit Orthopaedics.

Posted on Aug 22nd, 2014

Articular Cartilage Replacement with Dr. Rick Cunningham | VSOrtho

Articular Cartilage Replacement with Dr. Rick Cunningham

Articular Cartilage Replacement with Dr. Rick Cunningham of Vail Summit Orthopaedics.

Posted on Aug 22nd, 2014

ACL Repair with Dr. Rick Cunningham | VSOrtho

ACL Repair with Dr. Rick Cunningham

ACL Repair with Dr. Rick Cunningham of Vail Summit Orthopaedics.

Posted on Aug 22nd, 2014

Dr. Rick Cunningham in the Leadville 100 | VSOrtho

Dr. Rick Cunningham in the Leadville 100

Dr. Rick Cunningham completes the challenging the Leadville 100 Bike Race.

Posted on Aug 22nd, 2014

Richard Cunningham, M.D. of Vail Summit Orthopaedics | VSOrtho

Richard Cunningham, M.D. of Vail Summit Orthopaedics

http://vailknee.com Welcome to the practice of Richard Cunningham, M.D., a sports medicine specialist in Vail, Colorado. Dr. Cunningham is a board-certified orthopaedic surgeon who is fellowship-trained in knee and shoulder surgery. He is a partner at Vail•Summit Orthopaedics, which has been serving the Vail Valley and Summit County since 1979. With clinics near Colorado's largest ski resorts, Dr. Cunningham cares for professional and recreational athletes alike, helping people of all ages get back to their active lifestyle. Dr. Richard Cunningham Vail•Summit Orthopaedics Dr. Cunningham has cared for patients in the Vail Valley for nearly a decade. He is known for his kind and compassionate treatment. And, as an athlete himself, he understands the impact knee and shoulder injuries have on an active person's lifestyle. As a surgeon, he is widely recognized for reproducibly providing his patients with successful outcomes. He excels in the diagnosis and latest treatment of knee and shoulder conditions and is an expert in: Arthroscopic ACL Reconstructions Arthroscopic Meniscus Repair Cartilage Restoration Surgery Arthroscopic Rotator Cuff Repair Arthroscopic Shoulder Stabilization Surgery With extremely low complication rates and minimal downtime, Dr. Cunningham gives his patients the greatest opportunity for an excellent outcome. Sports Medicine Specialist Dr. Cunningham was trained in a prestigious sports medicine fellowship at the University of Pittsburgh. The program is considered by orthopedists to be the premier knee and shoulder fellowship in the United States. During this time, he was an associate physician for the Pittsburgh Steelers and Pittsburgh Penguins. Following his fellowship, he joined Vail•Summit Orthopaedics, where he continues to treat athletes of all levels. Dr. Cunningham is a Physician with the US Ski Team. He also serves as the team doctor for the Freedom FC Soccer Team. Dr. Cunningham helps provide medical coverage to the TEVA Mountain Games, Vail Rugby, Vail Lacrosse Tournament, and the Ski and Snowboard Club in Vail. He also serves as the team physician to local high schools and provides free sports medicine physicals to high school athletes every school year. Awarded For Excellence Dr. Cunningham is Chief of Surgery at Vail Valley Medical Center. In 2010, he received the Clinical Excellence Award from his physician colleagues at the Center. He is also a member of professional orthopaedic organizations including the American Academy of Orthopedic Surgeons, Arthroscopy Association of North America, and American Orthopedic Society for Sports Medicine. Caring For His Community Passionate about giving back to the community, Dr. Cunningham has provided free sports physicals for high school athletes as well as knee stability checks for skiers at the start of ski season. He believes strongly in educating people about knee and shoulder injuries and provides regular orthopaedic lectures to primary care and emergency medical physicians. He also gives a series of community lectures every year and offers information and tips to the public through various local news stories. Dr. Cunningham is married and has four children. He enjoys attending his children's soccer games, basketball games, and swim meets. He is also active in many outdoor activities and especially enjoys Nordic and Alpine skiing as well as mountain and road biking. Education Undergraduate: Amherst College, Amherst, MA Medical: University of Washington, Seattle, WA Training Orthopaedic Surgery Residency: University of Utah, Salt Lake City, UT Knee, Shoulder, and Sports Medicine Fellowship: University of Pittsburgh Center for Sports Medicine, Pittsburgh, PA Professional Affiliations American Academy of Orthopaedic Surgeons Arthroscopy Association of North America American Orthopedic Society for Sports Medicine Hospital Affiliations Vail Valley Medical Center Summit Medical Center

Posted on Jun 9th, 2015

Physical Examination of the Knee | VSOrtho

Physical Examination of the Knee

Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics explains the different physical exams of the knee. http://vailknee.com

Posted on Jun 9th, 2015

Knee MRI Anatomy | VSOrtho

Knee MRI Anatomy

Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics explains how to interpret an MRI of the knee. http://vailknee.com

Posted on Jun 9th, 2015

Arthroscopic Knee Surgery Meniscus Tear | VSOrtho

Arthroscopic Knee Surgery Meniscus Tear

http://vailknee.com Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics explains how he repairs a torn meniscus. The meniscus is a cartilage cushion, which rests between the bones of the knee and acts as a shock absorber. Meniscus tears are often repaired arthroscopically. Patients can either tear their medial (inside of the knee) or lateral (outside of the knee) meniscus. Medial meniscus tears are much more common than lateral meniscus tears. Symptoms of a Meniscus Tear Patients typically experience well-localized pain, popping or catching. Squatting usually increases the pain. There is often minimal swelling present. Unlike bone or muscle, meniscus tissue has very poor blood supply. As such it has a very low healing potential. Most patients tear along the thin, inner rim of the meniscus where there is no blood supply. These tears cannot be repaired. Instead, Dr. Cunningham removes just the torn portion of the meniscus and preserves as much of the healthy, functioning portion of the meniscus as possible. In a typical meniscus tear requiring arthroscopy, 10–15% of the meniscus has to be removed. If a patient has minimal arthritis (wearing of the coating cartilage on the end of the femur and/or tibia), then the patient can expect a great outcome. If there is a meniscus tear and arthritis, then the outcome is typically inversely related to how severe the arthritis (ie. the worse the arthritis, the less optimal the outcome). There is no need for crutches or a brace after arthroscopic menisectomy. Arthroscopic Meniscal Repair If the meniscus tissue is torn in the peripheral 3mm (where there is blood supply), the meniscus can be repaired and preserved. Repairing the meniscus is always Dr. Cunningham's preference. So called "bucket handle tears" where the meniscus tears longitudinally along the outer rim and then flips into the center of the knee like a bucket handle, are tears that Dr. Cunningham commonly repairs. The alternative to repairing these bucket handle tears is to remove 50% or more of the meniscus. Removing this amount of the meniscus, which is the "shock absorber" cartilage, is known to predispose the knee to early arthritis. The gold standard for repairing the meniscus is to pass sutures “inside-out.” While viewing through the arthroscope, sutures are precisely passed through the meniscus and tied over the capsule of the knee joint. There are newer “all inside” meniscal repair devices where sutures don't have to be passed through a small incision outside the knee. Dr. Cunningham uses these all inside devices for smaller tears or for hard to reach tears. Recovery and Rehabilitation The rehabilitation after a meniscal repair is more entailed than after an arthroscopic menisectomy. For a repair, the patient is kept in a knee brace with their knee locked straight whenever up walking for 6-8 weeks, depending on the size of the tear. However, immediately after surgery, we encourage you to unlock the brace or remove it when sitting down and start gentle knee range of motion exercises. After 6-8 weeks, the brace is discontinued, but no squatting is allowed for up to 12 weeks as this places high shear stresses on the repaired meniscus, and we want to be sure it has been given every opportunity to heal. Unfortunately, not all meniscus repairs heal despite our best efforts. This is again due to the poor blood supply and compromised healing potential of the meniscus. We do not do follow up MRI scans to confirm healing as these are unreliable. Instead, we look out for symptoms of a meniscus that did not heal, which are very similar to the symptoms patients had before surgery (catching, locking, well localized pain over the meniscus). To learn more about post-surgery rehabilitation, consult with Dr. Cunningham for more information.

Posted on Jun 9th, 2015

ACL Reconstruction Surgery | VSOrtho

ACL Reconstruction Surgery

http://vailknee.com Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics explains and performs Anterior Cruciate Ligament (ACL) Surgery. Anterior Cruciate Ligament (ACL) tears are a common knee ligament injury often occurring as a result of an athletic injury. Contact Dr. Cunningham to learn more. Anatomy of the ACL and Mechanism of Injury The ACL is one of the primary stabilizing ligaments of the knee. It originates from the back of the femur (thigh bone) and inserts on the front of the tibia (shin bone). It is about the size of your small finger but can withstand forces of up to 500 lbs. before it ruptures. The ACL minimizes excessive forward movement and rotation of the tibia in relationship to the femur. A tear of the anterior cruciate ligament (ACL) results from over stretching of the ligament. It is the most commonly injured ligament in the knee. How ACL Tears Occur An injury to the ACL can occur as the result of slow, twisting fall skiing or with a sudden deceleration in cutting and pivoting sports such as football, basketball or soccer. It is most often a non-contact injury. Women are 3–5 times more likely than male athletes to tear their ACL for a number of biomechanical reasons. The vast majority of ACL tears are complete tears, but one can occasionally suffer only a partial tear. Most people report feeling their knee give way, hearing a pop in the knee, and then having immediate pain and swelling. Pain is commonly located on the outside or lateral aspect of the knee. However, patients can also tear the medial collateral ligament (MCL) or medial meniscus, which can cause pain on the medial or inside of the knee. Immediate Aftermath of ACL Tear People can typically walk on the knee with pain after such an injury, but they may feel that their knee gives way or feels weak. Oftentimes, other structures, such as the meniscus cartilages, are also injured in the knee when the ACL tears. However, after 4–6 weeks, the knee can feel nearly normal and one can do non-athletic, everyday activities. However, if a person without a functioning ACL then suddenly twists or rotates on the knee, they may experience a giving way episode of the knee. Over time, these repeated giving way episodes damage other structures in the knee such as the meniscus and articular cartilage, leading to premature knee arthritis. To learn more about post aftermath, consult with Dr. Cunningham for more information. ACL Tears Do Not Heal On Their Own Unfortunately, tears of the ACL do not heal. The ACL is bathed in synovial fluid. When it tears, the small blood vessels that once surrounded it also tear and there is bleeding within the knee. However, the surrounding synovial fluid quickly dilutes this blood and therefore the healing potential is greatly diminished. In contrast, when the MCL tears, the bleeding that occurs is not washed away from the site of the tear by synovial fluid. In turn, this bleeding helps mobilize healing cells to the site of the MCL tear. These cells form collagen fibers, which act to bridge the torn MCL back to its native attachment site from which it tore away. Most MCL tears can therefore fully heal as long as the knee is protected in a knee brace so that the MCL does not heal in an elongated and lax position.

Posted on Jun 9th, 2015

Partial Knee Replacement | VSOrtho

Partial Knee Replacement

http://vailknee.com Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics explains and performs Partial Knee Replacement. Dr. Cunningham has many patients who have skied the bumps and steeps at Vail for many years. This can take a toll on one's knees. Many patients develop severe osteoarthritis in their knees and can no longer ski or do many of the activities that they enjoy. However, Dr. Cunningham is a board-certified and fellowship-trained knee and shoulder surgery specialist who offers the most advanced treatment options that get people back to the activities they enjoy. As a partner of Vail Summit Orthopaedics, Dr. Cunningham cares for many local patients living in Eagle and Summit Counties, Colorado (which includes the towns of Frisco, Breckenridge, Silverthorne, Dillon, Vail, Avon, Edwards, Eagle, and Gypsum). In addition he has many patients from Denver and the front range, as well as patients from around the country and world. Unicompartmental knee replacement is an option for a small percentage of patients with osteoarthritis of the knee. Your doctor may recommend partial knee replacement if your arthritis is confined to a single part (compartment) of your knee. Your knee is divided into three major compartments: The medial compartment (the inside part of the knee), the lateral compartment (the outside part), and the patellofemoral compartment (the front of the knee between the kneecap and thighbone). In a unicompartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the rest of the knee is left alone.

Posted on Jun 9th, 2015