Brian Gilmer, MD

Brian Gilmer, MD Knee Care Refined
Dr. Gilmer is a sports medicine and orthopaedic specialist with expertise in minimally invasive knee, shoulder, and fracture surgery.

Dr. Gilmer's clinical interests include treating multi-season mountain sport athletes. He specializes in arthroscopic and open surgery of the knee, shoulder, and ankle including anterior cruciate ligament tears, meniscal tears, shoulder rotator cuff and labral tears, and peroneal tendon tears. He is particularly interested in knee preservation and non-arthroplasty (joint replacement) treatments for cartilage injury. His academic interests include publications on minimally invasive knee repairs which can preserve the patient’s own tissue and avoid the need for reconstructions using grafts. He is on the editorial board of Arthroscopy Journal and has presented research at a host of national meetings. Board Certification
American Academy of Orthopaedic Surgery

American Orthopaedic Society for Sports Medicine

Arthroscopy Association of North America

Education
Texas A&M University, College Station, Texas - B.A. English, Minor Spanish. University Honors, Magna Cum Laude

University of Texas, Galveston, Texas - M.D. Doctor of Medicine, Summa Cum Laude. Class Speaker. President, Alpha Omega Alpha Medical Honor Society. President, Theta Kappa Psi Medical Fraternity. Medical Training
University of Washington / Harborview Medical Center, Seattle, WA - Orthopedic Surgery Residency
Chief Orthopedic Resident Teaching Award

Taos Orthopaedic Institute, Taos, NM - Orthopedic Sports Medicine Fellowship

Biography
Dr. Gilmer was born and raised in the Houston Texas area. He spent much of his childhood and early years around the Texas Medical Center with his mother who was a nurse at the University of Houston Health Science Center and later a nurse anesthetist at the renowned Texas Orthopedic Hospital. There he was exposed to great mentors in the field of Orthopedics who fostered his interest in medicine and clinical research. His childhood was spent largely outdoors hunting and fishing. He held a series of jobs from welding shops, to ambulance services, to guiding wilderness backpacking and whitewater trips in Alaska. He moved to Seattle for residency training and found passion in the outdoors. During his residency in Taos, New Mexico where he specialized in ski and snowboard injuries he was recruited by the Mammoth Orthopedic team

Dr. Gilmer, his wife and young son moved to Mammoth Lakes to be in the mountains. When not chasing his family, he can be found trail running with his dogs, Nordic and alpine skiing, or playing guitar by the fire. Honors and Awards
Eagle Scout Award, Boy Scouts of America
Alpha Omega Alpha Honor Medical Society
William Todd Midget Award - For fraternity, scholarship, humility, and humanity
Global Health Scholars Award
Excellence in Student Teaching Award
John P. Mcgovern Award in Oslerian Medicine - For emulating the life and principles of Sir William Osler
Esther Whiting Award
Chief Resident Teaching Award

Professional Memberships
Dr. Gilmer is a diplomate of the American Board of Orthopaedic Surgery (ABOS). He is also an active member of the American Academy of Orthopedic Surgeons (AAOS), Arthroscopy Association of North America (AANA), and the American Orthopaedic Society for Sports Medicine (AOSSM). He has served on committees within both the AAOS and AANA. Teaching and Professional Positions

Dr. Gilmer is a team physician for the US Ski and Snowboard Teams (USSA), and works in particular with the athletes of the US Freeski team. He has provided team coverage for the Dew Tour, XGames, and Mammoth Grand Prix. He provides support to the Mammoth Ski and Snowboard teams, and is medical director for the Mammoth Hospital Department of Physical Therapy and Rehabilitation. He has performed medical mission work in Mexico, Nicaragua, Belize, and Indonesia and has taught English as a second language (ESL) classes to Spanish speakers. Dr. Gilmer takes an active role in teaching by holding a clinical faculty position through the University of Nevada, Reno and by teaching arthroscopy to orthopedic surgery residents. He co-founded the Mammoth Orthopedic Institute to expand clinical research on sports related injuries in the Eastern Sierra, and established the Mammoth Sports Course as a venue for local, regional, and national providers to discuss controversial topics in sports medicine. Personal Statement
In 1890 the United States census announced that the frontier was closed and Frederick Jackson Turner penned his thesis that the American spirit of ambition and ingenuity had been forged by the frontier experience. A hundred years later I sat on the edge of a levy in Southeast Texas watching houses sprout across the fields where I roamed as a child, and I wondered if it were true. I resolved that if the frontier was closed, then I must find a new one, and soon. I have always been drawn to stories, and I am privileged that medicine has allowed me access to the stories of my patients. In the Eastern Sierra, these are often stories of adventure told by the new pioneers. People who are pushing the boundaries of their bodies and their sports led by a passion to explore and experience the world around them. In practice, I am interested not just in the story of what happened, but what future story my patients hope to write. This means the conversation is not just about your injury but your goals for treatment and recovery. I provide an individualized approach and a range of treatment options. I feel strongly that understanding the injury and the treatment plan are critical to successful outcomes and use diagrams, videos, and thoughtful discussion to improve that understanding. I am proud to remain in contact with many of my patients long after they have fully recovered and take ownership in the story of their lives. As a lifelong learner I am committed to maintaining cutting edge knowledge, technical expertise, and compassionate care. Despite all of our technological advances in the field of sports medicine, our patients are the real pioneers. They expect not just relief from pain but return of optimal function. They pass this expectation to their surgeons,

03/09/2026

Medoh Health Weighing the Options 2 of 4: Is there a difference in outcomes based on age or activity level?

Understanding meniscus tears—their causes, symptoms, and treatment options—so they can make informed choices about recovery and protecting long-term knee health.

This case highlights the ways in which PFJ arthroplasty in isolation does not resolve the underlying maltracking issues ...
03/07/2026

This case highlights the ways in which PFJ arthroplasty in isolation does not resolve the underlying maltracking issues that cause lateral patellofemoral arthritis. In fact, it can make it worse.

It is always important to consider why a young patient has isolated patellofemoral arthritis. Except in posttraumatic cases, this is going to be typically due to the same underlying risk factors for instability. 1) anteversion (or tibial torsion) 2) dysplasia 3) externally rotated extensor mechanism 4) valgus, or 5) some combination of the above.

Onlay implants that do not account for changing the version of the component risk overstuffing the joint or recurrent lateral instability, as seen in the images. This occurred very early after the index procedure.

Sometimes this can be avoided by externally rotating the patellofemoral joint implant. You have to create a notch at the superior lateral cortex, blasphemy I know, but it allows the trochlear component to accept the patella where it lies (superior and lateral). This works with the Arthrex IBalance PFJ. Other implants with a broader, shallower entry for the patellar can generate this effect with less need to rotate the trochlear implant as much externally. The Medacta patellofemoral arthroplasty has this geometry (as does the GMK sphere for TKA, in part, this is why it pairs with the KA alignment strategy).

Though there are more elegant ways to correct this problem, I chose a tibial tubercle osteotomy (Arthrex 5.0 headless compression screws) because the patient was miserable and did not want to wait for CT scans and additional planning. I could plan it off the preoperative MRI and X-ray and adjust it intraoperatively before fixing it with screws.

I combined this with an MPFL graft, treating it as any other instability case. I know this is controversial, and others may have varied opinions. I held onto this case for a long time before presenting it here to ensure that this approach would work, and it has proven durable.

Please chip in if you have suggestions or other experience with this.

03/06/2026

Weighing the Options 1 of 4: What are the pros and cons of surgery vs. conservative treatment?

Understanding meniscus tears—their causes, symptoms, and treatment options—so they can make informed choices about recovery and protecting long-term knee health.

Each year, Dr. Knecht with the Mammoth Orthopedic Institute, travels to Guatemala as part of a medical mission team dedi...
03/05/2026

Each year, Dr. Knecht with the Mammoth Orthopedic Institute, travels to Guatemala as part of a medical mission team dedicated to providing life-changing surgical care to communities in need. Their team includes surgeons, PAs, nurses, PTs, scrub techs, and sterile processing techs—each playing a vital role in restoring health and hope.
Last year, over just four intense days, the team performed 98 transformative surgeries. Dr. Knecht and his foot & ankle team alone completed 28 surgical cases, helping patients regain mobility and dramatically improving their quality of life.
Please consider supporting this incredible cause. Your generosity directly impacts patients who otherwise would not have access to essential surgical care.

Donate here:
https://teamhopeinmotion.org/donate

03/02/2026

Here is a nice tip we use for hybrid ACL repairs. Suture the ACL as you have for a typical Bunnell-type repair and secure these with a knotless 4.75 anchor to the femoral footprint at the AM. bundle location. This restores the more isometric AM bundle in a 'higher' position on the femoral wall and is a nice place to put either Vicryl sutures to hold a BEAR implant or a tape for an Internal Brace, depending on your preferences and the clinical situation, as length change is less of an issue.

Increasing footprint compression and getting some fibers to the lower attachment of the PL bundle can be hard because the view is now obscured. By placing the knee in figure-4 and using a curved guide as for a shoulder Bankart, the ACL will move away from the wall a bit, and you can place a knotless anchor such as a knotless fiber tak in this 'lower' position. Then shuttle the repair suture around the ACL with a knee scorpion, then convert the anchor and slowly tension it until you achieve the desired effect. Shown in the video is this tensioning, and you can see how the fibers rotate and approximate the wall as the anchor is reduced.

I call this a hybrid anchor technique because it uses a 4.75 knotless anchor and a smaller all-suture knotless anchor below.

Registration is open for the 2026 Mountain Orthopedic RendezvousJune  11-13,  2026Formerly The Mammoth Sports Course. Re...
02/25/2026

Registration is open for the 2026 Mountain Orthopedic Rendezvous
June 11-13, 2026
Formerly The Mammoth Sports Course. Register now before prices increase on March 13th. This year's focus is on the knee, from arthroscopy to arthroplasty, revision surgery, and everything in between. Expect in-depth discussion of current controversies, surgical pearls, and case-based learning focused on one of the most complex and high-volume areas in orthopedics.
https://site.pheedloop.com/event/MORe2026/home

I had been recommending my Thrive Protocol for patients mostly out of my own ignorance and because patients are frequent...
02/13/2026

I had been recommending my Thrive Protocol for patients mostly out of my own ignorance and because patients are frequently asking me how to augment and improve their surgical readiness and healing postoperatively. I trusted that my colleague and their founder Pat Denard had done the research in building his protocol. Also he provided a discount code (b.gilmer) for my patients at the checkout on his site.

More recently I decided I needed to spend the time to gain some knowledge and experience for myself with these products if I was going to recommend them.

They sent me some samples and I have been consistently using the strength and recovery mix for the creatine supplement in the mornings for about 3 months. There is good literature to support creatine supplementation with resistance training (which I’m doing twice a week on average) and Ive improved my bench and deadlift for the first time in years. There is also literature supporting a neuroprotective role which I suspect in going to need eventually.

I’m doing the opticharge after my runs. 3-4 miles 2-3 days a week with a long run on the weekend 5-7 miles. It’s winter. So there is some Nordic skiing in this mix which for me feels like running while breathing through a red plastic Coffee straw.

Optifuel after the weight lifting sessions especially if I am between meals because of the reported literature regarding improved muscle mass and strength.

I’ve gained a couple pounds for the first time in many years, in a good way.

There are people who know much more about this than I do. But this system works and now I can vouch for it to my patients as well.

Come to surgery strong. Don’t just heal. Recover.

Join Lake Tahoe medical providers for a one-day CME at the Lake Tahoe Sports Medicine & Primary Care Symposium!
01/30/2026

Join Lake Tahoe medical providers for a one-day CME at the Lake Tahoe Sports Medicine & Primary Care Symposium!

Lake Tahoe medical providers—join us for a one-day CME at the Lake Tahoe Sports Medicine & Primary Care Symposium!

Hear from orthopedic, PM&R, and wound care experts while exploring practical topics tailored to our active mountain population.

Learn more or register today:
https://bartonhealthfoundation.salsalabs.org/laketahoesportsmedicinesymposium2026/index.html

This is a great infogrpahic from Arthroscopy journal December edition.  I found this to be a helpful infographic that ap...
01/30/2026

This is a great infogrpahic from Arthroscopy journal December edition. I found this to be a helpful infographic that applies to all forms of ligament reconstruction. Sometimes faster or slower based on severity of injury. But no matter how severe the injury, surgeons must have constructs solid enough to allow for these milestones and not overly restrict the therapists, who must in turn help patients understand these phases and where they are and where they need to be, and walk the fine tightrope of who and when to push and when to encourage a slower pace. This also carries over to athletic trainers and strength and conditioning coaches and trainers who help in the later phases knowing about sport specific activities that are safe but continue to build strength and endurance, and finally to patients who have to be engaged in the process and do the work on their own, fighting the mental and emotional swings that come with these long recoveries. It takes a village to get the best results.

The only other note I would have here is that I think we are learning that there is an initial period that merits rest. I like that about 3 days after surgery, the knee quiets, rests, and the swelling peaks and starts to subside, so we don't perpetuate a hyperinflammatory state. There are various opinions on this, but I'm coming to see rest as a valuable part of recovery. It's an idea that is a little unpopular in the go-go, what-can-I-do-next-and-now culture we live in.

I am looking forward to speaking at the upcoming   Bash Salt Lake City event!
01/24/2026

I am looking forward to speaking at the upcoming Bash Salt Lake City event!

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9990 Double R Boulevard
Reno, NV
89521

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