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This was a cross-sectional study of sports medicine fellows from previous (2010–2015) and contemporary (2016–2021) training periods. There were 2315 trainees from family medicine (FM, 85%), 261 trainees from physical medicine and rehabilitation (PMR, 10%), and 133 trainees from emergency medicine (EM, 5%). PMR had the highest female and Asian trainee representation while FM had the highest Black trainee representation. There was no difference in female representation between training periods (30% vs 30%, P = 0.714). White trainee representation decreased between training periods (72% vs 65%, P < 0.001). Black (6% vs 6%, P = 0.894), Asian (15% vs 15%, P = 0.970), and Hispanic (6% vs 7%, P = 0.130) trainee representation was consistent between training periods. Female (participation-to-prevalence ratio, PPR = 0.59), Black (PPR = 0.48), Hispanic (PPR = 0.35), and American Indian/Alaskan Native (PPR = 0.17) trainees were underrepresented in sports medicine relative to the US population. Efforts to recruit underrepresented groups in sports medicine fellowship training may help create a more diverse workforce. [ABSTRACT FROM AUTHOR]

Background: The ideal graft for anterior cruciate ligament (ACL) reconstruction (ACLR) in young athletes has a high return-to-sport (RTS) rate and a low reinjury rate. Quadriceps tendon autografts are being used with increasing frequency for ACLR in this population, despite a paucity of evidence to support their use. Purpose: To report the RTS rate, ipsilateral reinjury rate, and contralateral ACL injury rate in a young athletic population undergoing primary ACLR using an all–soft tissue quadriceps tendon (ASTQT) autograft. Study Design: Cases series; Level of evidence, 4. Methods: Patients aged 14 to 22 years who underwent primary ACLR using an ASTQT autograft by a single surgeon between January 1, 2005, and April 30, 2020, were identified via electronic medical records and contacted ≥24 months after ACLR to complete a survey regarding subsequent ipsilateral or contralateral ACL injuries and RTS. Patients who had undergone previous ACLR (ipsilateral or contralateral) were excluded. Results: A total of 656 patients (330 male, 326 female; mean age, 17.9 years) were identified, and 395 patients completed the survey (60.2%; 174 male, 221 female; mean age, 17.8 years) with a mean follow-up of 73 ± 29 months (range, 24-139 months). The RTS rate was high (male: 87.7%; female: 82.8%; P =.19). Male and female patients had similar rates of revision ACLR (male: 12.6%; female: 10.0%; P =.40) and contralateral ACL injuries (male: 13.8%; female: 11.3%; P =.46). Conclusion: A high RTS rate and similar rates of ipsilateral and contralateral ACL injuries were found for male and female patients in a young athletic population undergoing primary ACLR using an ASTQT autograft. These results help one to better understand the utility of ASTQT grafts to support successful ACLR in young athletic populations, for which ASTQT grafts appear to yield favorable outcomes. [ABSTRACT FROM AUTHOR]

Introduction: As the average body mass index (BMI) is increasing at an alarming rate, dichotomous literature exists regarding whether BMI is protective or disadvantageous for fracture risk. Therefore, the purpose of this study was to evaluate the relationship between BMI, fracture complexity, and post-operative complications for tibial plateau fractures. Methods: A retrospective analysis of the National Surgical Quality Improvement Program's database for the years 2005–2018 was completed. Only patients undergoing primary surgical fixation of an isolated tibial plateau fracture were included. Patients were then stratified into unicondylar and bicondylar fracture patterns by CPT code. Multivariate logistic regression analyses were used to assess risk factors for fracture severity, post-operative complications, and staged fixation. Results: Of the 3454 patients identified for inclusion, we found that patients with higher BMIs were more likely to sustain a bicondylar fracture compared with patients with lower BMIs. For each additional BMI point, the risk of sustaining a bicondylar fracture increased by 1.0%. Additionally, there was a 3.8% increased risk of surgical complications for every increased BMI point. Specifically, the risk of a deep infection increased by 6.1%, wound dehiscence by 8.5%, and venous thromboembolism by 4.2%. Conclusion: This data demonstrates that an elevated BMI is associated with increased tibial plateau fracture complexity and post-operative complications. These results may be used to help surgeons and hospitals identify at-risk patients to help guide perioperative management in an effort to help mitigate such complications as much as possible. [ABSTRACT FROM AUTHOR]

COVID-19 altered National Football League (NFL) player and team training during the 2020 offseason. All preseason games were cancelled resulting in absence of game play before the first week of the regular season. Thus, concerns exist regarding injury susceptibility of players during regular season games. The purpose of this study was to evaluate and compare injury rates during the 2020 NFL season versus injury rates from the unaffected 2017–2019 seasons. We hypothesized there would be an increased injury rate and an increased rate of season ending injuries during the modified 2020 season. The NFL's public injury database was queried to identify players placed on the injury lists throughout the 2017–2020 seasons. All players listed as "out" and on the injured reserve due to physical injury were included in the data set. For further stratification, injury incidence was separated based on position. Time missed due to COVID-19 illness was not included. Injury rates were expressed as injuries per 1000 athlete exposures (AE). Overall, 893 individual players missed games due to injury during the 2020 NFL regular season compared to an average of 743 over the 2017–2019 seasons. Defensive players at all positions had a statistically significant increase in injury incidence from an average of 7.54 to 10.20 injuries per 1000 AE. Defensive backs were most affected with a 46% increase in players injured. There was no statistically significant difference in season ending injuries for any position. The COVID-19 stricken 2020 NFL regular season saw an increased rate and incidence of injuries. Specifically, defensive players had a higher incidence of injury overall with defensive backs experiencing the greatest increase in injury rates. [ABSTRACT FROM AUTHOR]