Purpose In the current COVID-19 pandemic, it is more important than ever to maximize communication in the scientific and medical community. In the context of academic meetings and conferences, there is the growing need for a set of guidelines secondary to the COVID-19 pandemic, and the growing environmental and economic challenges that large academic and medical conferences face. These Virtual Meetings Best Practices were established in response to the scant evidence and guidance on the topic. Methods These best practice guidelines were developed from a scoping review of peer-reviewed literature, grey literature and lay literature. MEDLINE and Embase databases were scoped for relevant, non-duplicate articles. For lay articles, Google searches were utilized. The recommendations that comprise this document are a compilation of nonexperimental descriptive studies (e.g. case studies) and expert committee reports, opinions and/or experience of respected authorities, and lay articles. Results We identified four phases of the meeting cycle: Pre-planning considerations, Planning, Accomplishing conference goals through execution, gauging Response and Engaging the target audience for future cycles (PrePARE). Akin to the Plan, Do, Study, Act Cycle of quality improvement interventions, this document is meant to drive meaningful initial and subsequent interventions in the meetings of the medical and academic community. This covers actions and preparation for registration, scheduling, speakers, attendees, event type, technology, monetization/marketing, dealing with disruptions, post-event deliverables, response and engagement strategies. Enhanced access to integrated, high-quality and efficient virtual meetings will establish a new norm as an effective alternative for innovative health research, education and information dissemination in orthopaedics and beyond. Conclusions Given the uncertainty of whether large in-person gatherings will be permitted, advisable or responsible later into the summer of 2020 and beyond, these guidelines will aid events being converted and scheduled as virtual-only meetings. As we move forward in the era of increased utility and utilization of virtual conferencing, these guidelines will serve as a benchmark and standard for surgeons in the field.

Objective: To synthesize the best evidence surrounding the efficacy of cannabinoids for acute pain in the clinical setting based on subjective pain scores and observed adverse effects. Design: Systematic review with meta-analysis. Data Sources: PubMed, Embase, Cochrane Databases, and Google Scholar. Eligibility Criteria: English-language randomized-controlled clinical trials comparing cannabinoids with placebo in patients with acute pain. Data Extraction and Synthesis: Study quality was assessed using the Cochrane risk of bias tool. All stages were conducted independently by a team of three reviewers. Data were pooled through meta-analysis and stratified by route of administration. Primary Outcomes and Measures: Patient-reported pain and adverse events (AEs). Results: Six trials (678 participants) were included examining oral (5 trials) and intramuscular (1 trial) cannabinoids. Overall, there was a small but statistically significant treatment effect favoring the use of cannabinoids over placebo (À0.90, 95% confidence interval [CI] À1.69 toÀ0.1, i 2 = 65%, p = 0.03). When stratified by route of administration, intramuscular cannabinoids were found to have a significant reduction in pain relative to placebo (À2.98, 95% CIÀ4.09 toÀ1.87, i 2 = 0%, p < 0.0001). No difference in effect was observed between oral cannabinoids and placebo (À0.21, 95% CI À0.64 to 0.22, i 2 = 3%, p = 0.34). Serious AEs were rare, and similar across the cannabinoid (14/374, 3.7%) and placebo groups (8/304, 2.6%). Conclusions: There is low-quality evidence indicating that cannabinoids may be a safe alternative for a small but significant reduction in subjective pain score when treating acute pain, with intramuscular administration resulting in a greater reduction relative to oral. Higher quality, long-term randomized-controlled trials examining whether there may be a role for cannabinoids in treating acute pain are required.

PurposeThe opioid epidemic has prompted an emphasis on investigating opioid‐sparing alternatives for pain management following knee arthroscopy. This review evaluated the effects of perioperative nonopioid adjunct analgesia on postoperative opioid consumption and pain control in patients undergoing knee arthroscopy. MethodsA systematic review and meta‐analysis was performed using the following databases: PubMed, Embase, Web of Science, MEDLINE, and SCOPUS. Prospective comparative studies assessing the efficacy of various perioperative nonopioid analgesic strategies in patients undergoing knee arthroscopy were included. Twenty‐five studies (n = 2408) were included. ResultsPre‐emptive nonopioid pain medications demonstrated a reduction in cumulative postoperative oral morphine equivalent (OME) consumption by 11.8 mg (95% CI − 18.3, − 5.4, p ≤ 0.0001) and VAS pain scores by 1.5 (95% CI − 2.3, − 0.7, p < 0.001) at 24 h compared to placebo. Postoperative nonopioid pain medications significantly reduced cumulative postoperative OME consumption by 9.7 mg (95% CI − 14.4, − 5.1, p < 0.001) and VAS pain scores by 1.0 (95% CI − 1.354, − 0.633, p < 0.001) at 24 h compared to placebo. Saphenous nerve blocks significantly reduced cumulative postoperative OME consumption by 6.5 mg (95% CI − 10.3, − 2.6, p = 0.01) and VAS pain scores by 0.8 (− 1.4, − 0.3, p = 0.03) at 24 h compared to placebo. Both preoperative patient education and postoperative cryotherapy reduced postoperative opioid consumption. ConclusionPerioperative nonopioid pharmacotherapy, saphenous nerve blocks, and cryotherapy for patients undergoing knee arthroscopy significantly reduce opioid consumption and pain scores when compared to placebo at 24 h postoperatively. These interventions should be considered in efforts to reduce opioid consumption in patients undergoing knee arthroscopy. More research is needed to determine which interventions can reduce pain outside of the immediate postoperative period and the potential synergistic effects of combining interventions. Level of evidenceII.