The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted because the recent literature has supported the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision. Choosing an appropriate management strategy depends on multiple factors such as patient demographics and location of the tear. Physical therapy remains a first-line treatment for knee pain secondary to meniscus tear and should be pursued in the setting of acute and chronic knee pain. Furthermore, there is a growing amount of evidence showing that elderly patients with complex meniscus tears in the setting of degenerative arthritis should not undergo arthroscopic surgery. Direct meniscus repair remains an option in ideal patients who are young, healthy, and have tears near the more vascular periphery of the meniscus but it is not suitable for all patients. Use of orthobiologics such as platelet-rich plasma and mesenchymal stem cells have shown promise in augmenting surgical repairs or as standalone treatments, although research for their use in meniscal tear management is limited.

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Background Healthcare workers have faced extraordinary work‐related stress in the face of the COVID‐19 pandemic. Physical therapy, occupational therapy, and speech‐language pathology providers at inpatient rehabilitation facilities may represent a distinct at‐risk subgroup for work‐related stress during the pandemic due to the usual nature of their job duties, including close physical contact and extended treatment times. Objective To evaluate the impact of the COVID‐19 pandemic on work‐related stress and occurrence of depression and anxiety in physical therapists, occupational therapists, and speech‐language pathologists during the first surge of COVID‐19 hospitalizations. Design Cross‐sectional survey. Setting Academic, freestanding inpatient rehabilitation facility. Participants Survey responses were collected from 38 therapists. Intervention A 26‐item electronic questionnaire containing a mix of multiple‐choice and open‐ended questions. Main Outcome Measures Positive screens for depression or anxiety as measured by the Patient Health Questionnaire‐9 (PHQ‐9) and the General Anxiety Disorder 7‐item (GAD‐7) scale, respectively. Results Seven individuals (19%) scored at or above the clinically significant cutoff of 10 on each the PHQ‐9 and GAD‐7, corresponding to increased risk for depression and anxiety. Therapists younger than 30 years old had significantly higher GAD‐7 scores compared to therapists between 30‐39 years old ( p < .05). Occupational stress was attributed to a number of causes including concerns for health and safety, unpredictable changes in hospital protocols and work assignments, acquisition of additional work duties, concerns about the ability to provide high‐quality patient care in a restricted environment, and the psychological toll of caring for patients with or recovering from COVID‐19. Conclusion This cross‐sectional survey highlights the impact of the COVID‐19 pandemic on occupational stress and mental health of therapists working at an inpatient rehabilitation facility during the first surge of COVID‐19 hospitalizations. This research may help institutions identify at‐risk individuals who may benefit from support and guide policy changes to resolve potentially modifiable factors at a systems level.

Objective:Using data from a longitudinal national sports injury surveillance program, this study aimed to calculate injury rates and describe injury patterns across high school swimmers and divers.Design:Descriptive Epidemiological Study. Athletic trainers (ATs) from participating high schools reported injuries from swimming and diving programs for the High School Reporting Information Online system.Setting:Convenience sample of high school boys and girls' swimming and diving injuries during the 2008 to 2019 school years.Patients or other Participants:High school boy and girl swimmers and divers (aged ∼14-18 years).Independent Variables:Exposure data on gender, location of injury (practice vs competition), mechanism of injury, and sport (swimming vs diving).Main Outcome Measures:Injury rates, rate ratios (RRs) with 95% confidence intervals, and other descriptive statistics were performed.Results:563 swimming and diving injuries occurred during 2 171 260 athlete exposures (0.26 per 1000 athlete exposures). Girls had higher injury rates than boys overall (RR 1.57, P < 0.05), in practice (RR 1.53, P < 0.05), and competition (RR 1.81, P < 0.05). In swimmers, most injuries were to the shoulder (48.6%), associated with the freestyle (67.3%), and classified as overuse/chronic (58.0%). Among divers, most injuries were to the head/face (36.6%) and from contact with the playing surface (68.3%).Conclusions:Girls had statistically significantly higher injury rates than boys. The shoulder and head/face were the most injured body parts in swimmers and divers, respectively. Swimming injuries were most frequently of an overuse etiology, whereas diving injuries were more likely traumatic. Coaches and ATs should be aware of these findings to develop targeted strategies for injury prevention.