2022 AOSSM Annual Meeting Kurt P. Spindler,MD,Presidential Address

It is truly a great honor and privilege to represent you in our 50th year. What a world-class team AOSSM has become in half a century. I’d like to thank all of the past presidents who have helped me, guided me, and led me over the last few years. I want to honor the 69 founding members of AOSSM, including one of our founding members who is in the audience. Thank you, Major Gladden, for being here; we wouldn’t be here without you. Unfortunately, an organization that is 50 years old has members who have departed our ranks. So I would like to have a moment of reflection and silence for those who have left us.

There are some other people to thank: first, my wife and family. Second, we have an awesome Presidential Line that works as a team with the Board of Directors, the Committee Chairs, and the Professional Team. The annual meeting doesn’t take place without that group. I want to thank my partners at Cleveland Clinic for the greatest job. I thank my colleagues at Vanderbilt Sports Medicine Orthopaedics for the first 20 years of my career. I thank all of the multicenter teams with which I have worked; it has truly been one of the most fun things I have ever done in my life. Countless colleagues and friends have molded me and helped me in my career, and I am appreciative. And to all of the fellows, residents, and medical students I have learned from and had the pleasure to educate, thank you so much.

We have a special honor for Bruce Reider, who has provided 20 years of service. We are honoring him by creating the Bruce Reider Scholarship, an annual scholarship that will be presented to an individual to fund attendance at the AOSSM meeting. Thank you, Dr Reider, for your 20 years of service as a master editor of our journals.

Now, let’s celebrate 50 years. That’s a long time, 1972 to 2022. I don’t think any of the founders of our organization thought it would grow to this. A half-century ago they started this organization, but the member engagement of each of you makes AOSSM what it is. And truly the engagement makes us who we are. It’s the collective talents for over 50 years that have developed into a championship team, a world leader in sports medicine and research. But in the future, things will change. We will still be a team, but the team will be more inclusive and more diverse, and that will be the key to our success.

I want to look back over the last 50 years and think about what some of the greatest athletes have said about teams. One of my favorite players when I was young, Dallas Cowboys quarterback Roger Staubach, said, “Have the right people, in the right places, working together.” Michael Jordan, who dominated basketball in the 1980s and is perhaps one of the greatest athletes of all time, said, “Talent wins games, but teamwork and intelligence win championships.” Soccer star Mia Hamm, who revolutionized some of the aspects of women playing soccer, said, “I am a member of a team, I rely on the team, I defer to it, sacrifice for it, because the team, not the individual, is the ultimate champion.” Certainly, she helped popularize women’s soccer, but something else that helped all women’s sports is also 50 years old: Title IX, which had a huge impact on our field, on women’s athletics, and on education. Serena Williams has dominated women’s singles tennis, but she was also an outstanding doubles player, with career slam wins. She said, “Every woman’s success should be an inspiration to another. We are strongest when we work together and cheer each other on.” And finally, how could anyone who watched the Olympics in 2016 forget Simone Biles? Biles, the most highly decorated gymnast, has said, “The team comes first.”

So, what do the greatest athletes of all time think? They don’t think about themselves. They recognize that their success is team success. And team success depends on players, coaches, medical staff, strengthening and conditioning staff, and equipment.

Now I would like to look at some of the highlights from the last 50 years. We will start with our founders; our past presidents; the growth of fellowships, journals, and research funding; and the intangibles that make up the AOSSM culture. Our founding members, who were really quite bold, separated from the Academy and said, “We need to do something, we need to have our own society in sports medicine, we need to have our own meeting in sports medicine.” They created the annual meeting, a way to bring everyone together to contribute their own ideas and talents—the same way it is today. They created a forum for education. What initiative they had—very, very bold. Also in 1972, independently, several members began a scientific journal we know today as AJSM, which also celebrates its 50th anniversary.

I want to thank our past presidents. Each past president has left an indelible mark on AOSSM and has shepherded our society through 50 years of change. It’s incredible to think about what has changed in society and healthcare: the advent of arthroscopy, MRI, electronic medical records, internet, iPhone, CAQs, and many more. Orthopaedic specialization has rapidly evolved. In 1990, almost 50% of orthopaedic surgeons considered themselves generalists; now it is down to about 20%. The proportion of orthopaedists who consider themselves generalists with a special interest has also declined. So obviously specialization is taking off. In 2016, the last time it was measured by the Academy, the proportion of orthopaedists who consider themselves specialists was 60%, and it continues to increase. Most orthopaedic surgeons now consider themselves specialists, and this will have huge implications on how they are educated, what meetings they go to, and what additional training they pursue. Our fellowships, one of our crown jewels, have increased in 20 years from 58 sites to 90 sites and from 128 fellows to 225 fellows. Intangible member values are part of the culture we have: fun events at a meeting, gathering of team physicians for collaboration and discussion, fellowship training, being a mentor, being mentored, and developing friendships. These indelible friendships are continuously fostered.

Our journals are another crown jewel. AJSM started in 1972, and then we had Sports Health in 2009, OJSM in 2013, and VJSM in 2021. In 2021, AJSM had 1.4 million downloads, Sports Health had 2 million downloads, and OJSM had 2.5 million downloads. This shows the impact that an open journal has. And finally, as we have evolved, VJSM was started; in 2021, VJSM had 27,000 views of its videos. So our journals have been tremendous. We have been very fortunate to have had only had 3 editors of AJSM: Dr Hughston, Dr Leach, and Dr Reider. With that kind of sound leadership and stability, it is no wonder AJSM is the premier journal.

Research grant funding is a topic near and dear to my heart. AOSSM has invested in and is one of the first societies to promote research growth and funding. From 1988 to 1992, we provided $75,000 in grants, but in the last 4 years, 2018 to 2022, we provided $2,075,000. How did that happen? It happened with industry support, and it also happened with the “million dollar drive,” which I will talk about more. Among the crown jewels of our research funding are the IKDC, the IKDC-CAT, and the MARS study. The fact that we can have this kind of support leads us to our historic sports medicine research grant, which I will tell you about later.

Where is AOSSM in the present? The annual meeting is largely the responsibility of our outstanding professional team led by our CEO, Greg Dummer. We have a new website, developed from new technology, with an entirely new platform and some unique features. One of these features allows members to easily access all of the articles that appeared in our journals over the last 50 years. This is Version 1.0, so it will get better with time.

AOSSM runs by leadership engagement. It runs by all who participate in this society. Big committees with many members involve research, education, and self-assessment. There is the Presidential Line, Board of Directors, and Medical Publishing Board. All told, 198 people are engaged on an annual basis in helping the society promote education and research. Look at our members’ engagement in journals. Our editors, associate editors, assistant editors, and editorial board members total 448 people. We have several thousand reviewers. We have a medical publishing team headed by Bruce Reider as editor. What about member participation in the annual meeting? There are 503 members here, 50 reviewers for the abstracts, 155 posters, 54 moderators, and 176 podium presentations. The program committee this year was headed by Rick Wright and Cassandra Lee, and we are truly indebted to them for such an outstanding program. If we consider all of the people who are engaged in the society, if we take the leadership, the journals, and the people participating, that is over 1000 people. Every person attending this meeting is engaged with the society. We want to engage all of you because the engagement of each member makes our society strong.

Our research portfolio is significant. We have the O’Donoghue, Cabaud, and Excellence in Research awards, which are manuscript-based. Regarding clinical studies, the MARS seed funding from this society engaged 23 of our members, 55% in private practice, at 52 sites. This was an NIH-funded study led by Rick Wright, funded twice, and it has had multiple publications. And finally, we created the original IKDC, which was very forward thinking. And now we have invested in the Computer Adapted IKDC. We also conduct annual and sponsored grants and think tanks. This is possible, and will increase in the future, only because of the philanthropic funding that was spearheaded by Neal ElAttrache and the 2 to 1 match from Stanley Druckenmilller and Kenneth Langone, called the “million dollar drive.” We are very grateful to everyone who contributed to that drive and matched the contributions.

We have two award winners to announce. The first is for the Multicenter Award. Our Multicenter Award, which is patterned on MARS, funds an established multicenter group so that they can continue their work and apply for external funding, like the DOD and the NIH. We had 4 outstanding presentations, and our review committee consisted of people from the Academy, OREF, and AOSSM. The winner is “Jupiter 4.0: Risk Factors for Failure of Isolated Medial Patellofemoral Reconstruction,” by Dr Shubin-Stein and Dr Parook. This award is a collaboration with AOSSM, AAOS, OREF, and Aircast. It is a novel collaboration, and it works so well that the Academy is now using this model to provide grant awards in support and in matching with other subspecialties in the future. Congratulations to the Jupiter team.

The second award is the Emerging Leaders Multicenter Award. With this award, we wanted to select a group that wasn’t established and provide them seed funding to get together, work together, and build an infrastructure. This award goes to Eric Baumann for “Management of UCL Injuries in Throwers: a Prospective Multicenter Cohort.” The Emerging Leaders Multicenter Award was Jim Bradley’s idea and shows how the Presidential Line works. During a call, he had a great idea and then we put it together and awarded this grant. Congratulations to Eric Baumann and to the group he will lead.

What about the next 50 years? Where are we going and what will we do? I think Isaac Newton said it better than anyone else: “If I have seen further than others, it’s by standing upon the shoulders of giants.” Thus, we should act boldly, like our founders. We should hardwire our core values; we should create a dynamic strategic plan. The Dow Jones Industrial Average, as most people know, affects our financial portfolio and retirement portfolio and everything we do. What can the history of the Dow Jones teach us? The Dow Jones Industrial Average is made up of the largest industrial companies in America. In 1972, there were 30 companies in this index: 50 years later, only 3 companies are still at the premier level. Yes, 27 companies have dropped out; 90% have fallen away in 50 years. So we should celebrate the fact that during this time our premier publication, AJSM, has grown, improved, and become world-class. That is a tremendous achievement, but we also must be humble. We don’t want to be one of the 90% to fall out in the next 50 years. We need a strategic plan; we need to keep our eyes on the ball and on changes in education. Just like our journals have pivoted and grown, the society needs to pivot and grow to meet the changing needs of our members.

The strategic plan was a Board-approved year-long process. We set up a steering committee that was diverse and inclusive, commissioned by the Board to conduct qualitative and quantitative research with an outside consultant. The committee met virtually, spent 1 day together in January making the first draft, met virtually again to hone the draft, and presented this draft to the Board at the April meeting. The Board reviewed the draft and made modifications and then unanimously approved the document at our spring Board meeting. I am very grateful to all the people on the steering committee for making this happen.

What is our vision for the future? We want to treat athletes and people of all ages and abilities so they can enjoy active and productive lives. We will do this by facilitating world-leading, evidence-based diagnosis and treatment so that all orthopaedic sports medicine surgeons can guide their patients to a safe return to physical activity. We will hardwire AOSSM core values that make up the culture of our organization; we will continue to promote lifelong learning focused on scientific and practice innovation; we will encourage mentorship and development of the next generation of leaders; we will lead in clinical and research collaborations that promote team-based, patient-focused care; we will show compassion for patients, families, and coworkers; and we will be advocates for personal, professional, and institutional diversity and inclusion. These are our values. These haven’t changed over 50 years and should never change over the next 50.

We have 2 pillars in the AOSSM. The first is education and the second is research. Our goal in education is to acquire knowledge. We want to learn and apply evidence-based care in treating athletes and all active people. We have a unique website that allows customization for each member in order to drive the educational content they need at different points in their careers. We want to create partnerships. We want to increase the diversity of our educators and instructors. In research, we want to contribute to the discovery of independently vetted techniques and therapies to improve patient outcomes. We want to drive multicenter research. We want to mentor new and emerging sports medicine surgeons and professionals. We want to collaborate with partner institutions like the Academy, maybe the Arthritis Foundation, maybe the NIH. We want to diversify our funding sources.

There is a foundational community by which we work, and this community should represent a diverse, inclusive, engaged, and supportive fellowship of peers who are committed to advancing the care of athletes and the profession of orthopaedic sports medicine. This community should strive for 3 goals: practice or inclusion, AOSSM member value, and developing the team physician. “Practice or inclusion” means that we want to support all orthopaedic surgeons who are treating sports and active lifestyle injuries to know the best care and the best clinical practice. For member value, we want to customize membership so that we provide the right education at the right point in a member’s career of treating patients and being an orthopaedic sports medicine physician. Regarding the team physician, we all know that the care provider for the athlete, which used to be one physician on the sideline, now is multiple physicians and a lot of people who are not physicians, including our partners in physical therapy and athletic training and now exercise coaches. We want to provide a forum so we continue to educate these professionals as they lead teams or participate in teams so we can get the safest return to sport and the safest long-term care for the athletes. We are very fortunate and very celebratory, our past accomplishments are significant, and our current position is excellent; all of this provides an outstanding opportunity to advance our society as a world leader of education and research. This will require membership engagement. This will require work from our journals, our industry partners, and philanthropy. I want to give a shout-out to all of our industry partners and a special recognition to our platinum sponsors, who make up our corporate advisory board. Without industry support we couldn’t provide the type of programming that we have at the annual meeting, and a lot of industry support helped with initial grants that established many other grants for our society and our society members who have been funded by the NIH and others.

Finally, we have a very bright future for the next 50 years. Our strategic goals will require teamwork. Our society and teams will be inclusive and diverse. And our members’ talents and active participation within teams will enable AOSSM to achieve the best outcomes for athletes and patients. So, get engaged, join a team, lead a team, help a team, and contribute to a team. Thank you very much.