Sport medicine, infections and orthopaedic education: what we learned in Italy| Lo Scalpello - Journal

During the SARS-CoV-2 pandemic, Italy was the first country for the number of new positive cases of infection from the 8^th of March 2020 to March 21^st and the first for total number of deaths from the 19^th of March to April 12^th, 2020 ^1-4. The Italian National Health System adapted most of its medical units into COVID-19 care units, and suspended deferred treatments, surgeries and outpatient visits to dedicate human and material resources to Intensive Care Units (ICU) beds.

Many surgical residents have also been involved in COVID-19 departments and vaccination campaigns, consequently sacrificing their Residency Programs as well, interrupting hands-on training in the operating room and in-class lectures. In-fact, in a national survey conducted by Federspecializzandi it was found that the pandemic had a “negative” or “very negative” impact for 80% of residents ⁵.

On March the 9^th 2020, the Italian government imposed the national “lockdown”. Orthopaedic surgery was mainly focused on treatment of non-deferrable fractures and all kind of elective surgery were delayed. In addition, also scientific updates were affected, since congress activities were canceled or replaced by virtual conferences.

The VII National Congress of the Italian Association of Residents in Orthopedics and Traumatology (AISOT), held in L’Aquila (Italy) on September the 10^th and 11^th 2021, has been the first in-presence congress post lockdown. The discussed topics were Sport medicine, infections and Residents education ⁶.

Minimally invasive orthopaedic surgery in athletes decreased from 44.6 to 20.4% of the totality of surgical procedures since March 2020 to make way for emergency surgery ⁷. These data, together with the Residents’ opinion, suggest that the academic world should apply new approaches for the training program to keep up with the future. The simulation of the surgical act with virtual, augmented and mixed reality could be a good alternative to more expensive cadaver lab activities ^8,9. In fact, during the VII AISOT National Congress the main workshop topics focused on education of surgical techniques through arthroscopic simulators and saw bones.

Even the Italian Minister of University and Research, who participated in the congress, underlined the importance of rethinking the post-graduate schools. The key point discussed focused on improving the network relations between Polyclinics, General Public Hospitals, Teaching Hospitals, Primacy Care Trust, University, and Territory, and setting the number of access to future specialization grants to 12,000 per year ¹⁰ to clear the bottleneck by offering a position for every medical graduate student.

Finally, as young Orthopaedists, we also want to highlight and empathise the importance of the Italian Arthroplasty Registry ¹¹, which represents a cornerstone for a national epidemiological and scientific point of view, placing ourselves at the level of other countries.

In this issue of Lo Scalpello Journal, we have collected the best works from Residents presented at the VII AISOT National Congress, with the perspective of having AISOT recognized as a solid, active and valuable scientific society in the future.

The Authors are confident that an honest scientific commitment, carried out by major national societies, such as AISOT, SIOT and OTODI, if inserted in a logic of sharing and solidarity throughout the national territory, will lead to a bright future for the entire orthopedic community.

References

1. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report 83. Data as received by WHO from national authorities on April 12th. 2020.
2. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report 60. Data as received by WHO from national authorities on March 19th. 2020.
3. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report 48. Data as received by WHO from national authorities on March 8th. 2020.
4. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report 62. Data as received by WHO from national authorities on March 21st. 2020.
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10. Italian Law n.234. 2021.
11. Italian Law n.221. 2012.