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Background: In response to the COVID-19 pandemic, many US health systems suspended elective surgery at the recommendation of the US Surgeon General. This dramatically decreased case volumes for orthopaedic sports medicine fellows at academic institutions. Purpose: To describe how the COVID-19 pandemic has affected the education of the sports medicine fellowship class of 2020 as well as the subsequent effects on their career plans and psychological well-being. Study Design: Cross-sectional study. Methods: A 33-item survey was distributed via email to all American Orthopaedic Society for Sports Medicine (AOSSM) 2020 fellow members on April 22, 2020. Frequencies are presented as raw totals and percentages of respondents. The Fisher exact test was used to determine statistical significance between nominal variables, with significance set at P < .05. Results: Of 210 registered fellows, 101 (48.1%) responded. Before the COVID-19 outbreak, the typical case volume per week for most fellows (47.5%) was 11 to 15 cases. From the enactment of COVID-19 mitigation policies to the date of survey completion, 90.1% of fellows had performed fewer than 20 cases. A total of 32 fellows were presented with redeployment options by their fellowship program, with 10 redeployed mandatorily to other hospital departments. Fellows reported that web-based didactics (n = 100) and web-based journal clubs (n = 72) were utilized as alternative supplements in the absence of clinical education. There were 8 respondents who had either their prior contract or job offer rescinded, while 1 had a signed contract voided. As a result, 6 fellows now plan to matriculate into a previously unplanned fellowship. Also, 10 respondents’ intended practice start date was being delayed by their employer. Respondents whose postfellowship plans were affected were statistically more likely to experience doubts about readiness for practice (58.8% vs 20.3%, respectively; P = .005), anxiety about future career plans (94.4% vs 63.8%, respectively; P = .01), anxiety about their financial situation (86.7% vs 50.8%, respectively; P = .018), stress in personal relationships (58.8% vs 29.9%, respectively; P = .045), and signs or symptoms of depression (41.2% vs 11.1%, respectively; P = .007) compared with those whose plans were not affected. Conclusion: This survey illustrates that during the early stages of the COVID-19 pandemic and the subsequent suspension of elective surgery, there have been downstream effects to this group’s education, careers, board certification timeline, and potentially their social and/or emotional well-being.

Hip surgical techniques have evolved significantly, transitioning from open techniques to arthroscopic techniques. Hip arthroscopy has many advantages over open techniques, including reduced trauma to surrounding tissues, reduced risk of infection, and improved patient-reported outcome measures. Hip arthroscopic techniques are now commonly used for pathologies such as femoroacetabular impingement (FAI). FAI can include cam, pincer, or mixed impingement. Through hip arthroscopy, FAI may be treated with a femoroplasty and acetabuloplasty along with addressing any labral pathology that may exist. Owing to the capsule playing an integral role in hip stability, surgeons are now mindful of the initial approach and closure on completion of the intra-articular procedure. The most common approach for capsulotomy is the inside-out approach. However, this approach can be difficult in patients with a large pincer deformity. The authors describe an outside-in approach to arthroscopic hip capsulotomy. This capsular approach helps protect the labrum and articular cartilage while preserving capsular tissue.

The competitiveness of sport continues to increase with the corollary increase in sport technology. Sport technology is an umbrella that encompasses biometrics, wearable technology, and data analytics. Central to sport technology is a close relative, sport analytics. If sport technology is the general term for measuring what the athlete is experiencing from a performance standpoint, then sport analytics is the process of cleaning, processing, and manipulating these variables into meaningful output. The number of variables that can be collected are extensive but can be generally categorized into internal and external metrics. Internal metrics seek to measure how the athlete responds to training load (HR, HRV, Hormones, Sleep patterns). External metrics seek to measure how much work the athlete is performing (Live player tracking, Countermovement Jump, Isometric Mid-Thigh Pull). Internal and external metrics are continually evolving in the manner they are collected which depends on the time, resources, and staff allocation of an organization. This is where the collaboration between sport scientists and sport performance staff can come together to overlay variables and find relationships. There is no correct way to analyze data because each organization will have their own goals. For example, data could be used for injury mitigation, readiness assessment, or simply to establish baseline values. Some common statistical techniques that can be used include correlation, regression, and principal component analysis (PCA). However, performing these calculations may be complex and some organizations may lack a practitioner which can limit their ability to use data. In seeing this gap, the authors propose a qualitative approach to workload monitoring made for basketball but can be applied to most sports. The purpose of this paper is to empower sports performance staffs to learn and implement the basics of qualitative athletic monitoring approach.

Background:We currently know BFR training is a viable modality for strength gains in the healthy population. However, it is unknown the effect of BFR training on post-surgical and clinical populations. Furthermore, the optimal use of the BFR modality regarding resistance vs. no-resistance (bodyweight) is also unknown. This literature review adds new information to the field of BFR training specifically in the post-surgical and clinical populations. The objective of the study is to explore the validity and efficacy of blood-restriction training (BFR) in conjunction with low-load resistance training (LL-BFR) versus low-load training without BFR and high-load resistance training without BFR to determine which is superior for strength gains. Methods: The authors used SPORTDiscus, EBSCO, PubMed, and Science Direct to search for peer-reviewed articles. The articles chosen had the keywords/phrases "BFR, " "vascular occlusion, " "strength training, " "resistance training. " The studied emphasized patients with either clinical conditions (osteoarthritis) or musculoskeletal injuries (ACL reconstruction, total knee arthroplasty, knee arthroscopy). One hundred seventy-one articles were screened, and 17 articles reviewed. Results: BFR, in conjunction with low-load resistance training yields superior strength gains when compared to lowload training alone (p<.05). The outcome measures show a higher 1-rep max (isotonic strength) and greater muscle size (cross-sectional area, muscle mass, muscle volume) (p<.05). However, BFR with low-load resistance training does not yield superior strength gains in comparison to high-load resistance training alone (p<.03). Conclusion:As healthcare providers treating patients with musculoskeletal conditions, we know the importance of resistance training as a tool for rehabilitation and activities of daily living. However, at times heavy resistance training is contraindicated either due to joint instability/degeneration, pain, surgical restrictions. BFR training can be implemented with a 10-30% 1-rep max for comparable strength gains. This can be a potential tool used to offset post-surgical atrophy and atrophy due to arthralgia seen in certain systemic conditions. This can translate to better functional outcomes in post-surgical patients and superior quality of life in the geriatric population.