AAOS After COVID: Are We at a New Normal Yet?

I was so ready to hit the ground running. After the pandemic sidelined everyone from the tradeshow floor for over a year, the mile-long San Diego Convention Center floor lined with exhibitors stretched before me. I hoped the American Academy of Orthopedic Surgeons (AAOS) 2021 meeting Aug. 31- Sept. 3 marked my final sprint across the finish line to post-pandemic normalcy, a return to my life of business travel and seeing colleagues and clients in the flesh.

I wasn’t sure what to expect. It feels strange to me that the United States is a no-fly zone for so many other countries because of the resurgence of COVID-19. I knew this would not be the AAOS of 2019, but I wasn’t sure what to expect.

I appreciated the rigorous and repeated checks of vaccination cards. I was sensitive to fellow attendees’ level of comfort for contact. I offered waves from six feet away, elbow bumps, handshakes, and even a hug or two depending on how that initial awkward greeting moved the conversation forward.

I was surprised by the high number of vendors and low number of everyone else. Attendance was down from its usual 10,000 attendees to about 2,800. Few if any participants from outside the United States made the conference.

Still, we were all clearly very happy to be there in person. I was so thankful to be in the same room with the people who keep me engaged in the industry I love so much. My meetings were fewer in quantity, but deeper in complexity.

Andy Fauth, chief technology officer for OsteoCentric Technologies, was one of many peers I was happy to see in real life after 18 months of Zoom. AAOS is a must-attend for his five-year-old company.

“These meetings are a tremendous business development opportunity as far as manufacturing partnership, distribution, licensing, and other aspects of business,” he said. “[Pre-pandemic] these meetings were like the Super Bowl where you could meet with everybody. I felt like there was a decent industry turnout, but I do know that a lot of companies severely cut back on their employee attendees.”

For Fauth, it was essentially a dress rehearsal for next year’s conference in Chicago March 22-26.

“It’s an Academy in the middle of summer and six months before the next one. I think it’s unprecedented,” he said. “I feel like for us it was a really good step toward getting back to in-person meetings and also a great dry run for Academy 2022. For a new company like us with emerging technology, it gave us a chance to see what worked and didn’t work with our booth.”

He was ready for lower numbers, and he made the most of the people he did see.

“We made a conscious decision to support the Academy knowing it could be lower attendance,” he said. “We’re a technology-based company, and our surgeon interactions are paramount. I think people are so hungry for that face-to-face interaction and getting back to innovating that the meetings we did have were long and more meaningful. It just forces us to get more creative.”

The most creative approach I saw on the tradeshow floor was a booth hosted by a laptop manned by a remote company representative from abroad. Maybe not as engaging as a human body, but it also struck me as the quintessential solution to a 2021 problem.

The dearth of international attendees is a point I continue to ponder. With so many clinical studies that take place outside the U.S., what does this do to our innovation pipeline? The United States is a significant market for European and Asian companies. For so many, AAOS is about business development as much as product meetings. Surgeons from other countries come here to see what technology they might want to bring home.

Entrepreneurs who were kept outside our borders by the pandemic missed their chance to find the resources they need to incubate their ideas. From a community-building/philanthropy standpoint, how many life-saving, life-enhancing projects abroad aren’t happening because the United States is a COVID hot zone?

Fauth shares my concerns about the ripple effects of lost opportunities with an international audience.

“It’s hard,” he said. “Especially when you’re talking about companies in different countries and working together. That’s how they start and grow. [OsteoCentric Technologies is] primarily U.S.- focused right now, but that doesn’t mean we don’t have conversations [with international clients]. It’s hard to do over the phone with that layer of separation. We do some manufacturing overseas. Not being able to meet face-to-face, it does make it more difficult.”

It wasn’t just folks from overseas who skipped the show. The surge of the Delta variant also affected how many surgeons, vendors, and executives who could make it domestically.

“I do think [attendees] were minimizing their exposure, but I also think the number of times they can travel is challenging,” Fauth said. “The Academy was the first in a series of shows this fall. What we’re seeing with a lot of them is they want to come back, but their institutions are hesitant.”

I understand the hesitation. The sheer volume of tradeshows coming up as the industry tries to catch up from pandemic cancellations and postponements has my calendar full and my head spinning. I’m also staggering how I staff these trips to try and manage the inevitable backlog. With every day away from my desk, I’m getting further behind on competing priorities that keep me in business.

I’m not sure this is what I can call my “new normal” yet. The pandemic has proved to me that we’re far more adaptable and versatile than we know, so maybe “normal” isn’t so much a predictable outcome as a mindset, a willingness to make the best of whatever strange circumstances I find myself in. Maybe “normal” isn’t what we need so much as “balance.”

So I’ll adjust my in-person greeting as needed to show colleagues I care about their fears. I’ll hug my kids goodbye and hello, get on and off airplanes, get my nose swabbed, and flash my vaccination card. I’ll adjust my schedule and my expectations to accommodate the shifts of a life that nobody ever really considered normal in the first place, including me. 

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Dawn Lissy is a biomedical engineer, entrepreneur, and innovator. Since 1998, the Empirical family of companies (Empirical Testing Corp., Empirical Consulting LLC, and Empirical Machine LLC) has operated under Lissy’s direction. Empirical offers the full range of regulatory and quality systems consulting, testing, small batch and prototype manufacturing, and validations services to bring a medical device to market. Empirical is very active within standards development organization ASTM International and has one of the widest scopes of test methods of any accredited independent lab in the United States. Because Lissy was a member of the FDA’s Entrepreneur-in-Residence program, she has first-hand, in-depth knowledge of the regulatory landscape. Lissy holds an inventor patent for the Stackable Cage System for corpectomy and vertebrectomy.