Physical Therapy as Effective as Surgery for Torn Meniscus and Arthritis of the Knee, (Human) Study Suggests

Just One of Many Studies Published on This Topic-

My programs for conservative (no surgery) treatment are clinically and anecdotally successful. So, this means that clients and veterinarians do the work and get good results.

Physical Therapy as Effective as Surgery for Torn Meniscus and Arthritis of the Knee, (Human) Study Suggests –

“Surgery may not always be the best first course of action.

A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. To reinforce that, this study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.” Mar. 21, 2013 — A New England Journal of Medicine (NEJM) study showing that physical therapy is just as effective as surgery in patients with meniscal tears and arthritis of the knee should encourage many health care providers to reconsider their practices in the management of this common injury, according to the American Physical Therapy Association (APTA).

The study, published March 19, showed no significant differences in functional improvement after 6 months between patients who underwent surgery with postoperative physical therapy and those who received standardized physical therapy alone.

“This study demonstrates what physical therapists have long known,” explained APTA President Paul A. Rockar Jr, PT, DPT, MS. “Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. This study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.”

According to lead physical therapist for the trial and American Physical Therapy Association (APTA) member Clare Safran-Norton, PT, PhD, OCS, “our findings suggest that a course of physical therapy in this patient population may be a good first choice since there were no group differences at 6 months and 12 months in this trial.

These findings should help surgeons, physicians, physical therapists, and patients in decision-making regarding their treatment options.”

Researchers at 7 major universities and orthopedic surgery centers around the country studied 351 patients aged 45 years or older who had a meniscal tear and mild-to-moderate osteoarthritis of the knee. Patients were randomly assigned to groups who received either surgery and postoperative physical therapy or standardized physical therapy. Within 6-12 months, patients who had physical therapy alone showed similar improvement in functional status and pain as those who had undergone arthroscopic partial meniscectomy surgery. Furthermore, patients who were given standardized physical therapy — individualized treatment and a progressive home exercise program — had the option of “crossing over” to surgery if substantial improvements were not achieved. In this situation, thirty percent of patients crossed over to surgery during the first 6 months. At 12 months these patients reported similar outcomes as those who initially had surgery. Seventy percent of patients remained with standardized physical therapy.

According to an accompanying editorial in NEJM,”millions of people are being exposed to potential risks associated with a treatment [surgery] that may or may not offer specific benefit, and the costs are substantial.” Physical therapist and APTA member Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT, chief of physical therapy at Harvard University, said, “Physical therapists are experts in improving mobility and restoring motion. The individualized treatment approach is very important in the early phases of rehabilitation in order to achieve desired functional outcomes and avoid setbacks or complications.”

Story Source:

The above story is reprinted from materials provided by American Physical Therapy Association. Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:
Jeffrey N. Katz, Robert H. Brophy, Christine E. Chaisson, Leigh de Chaves, Brian J. Cole, Diane L. Dahm, Laurel A. Donnell-Fink, Ali Guermazi, Amanda K. Haas, Morgan H. Jones, Bruce A. Levy, Lisa A. Mandl, Scott D. Martin, Robert G. Marx, Anthony Miniaci, Matthew J. Matava, Joseph Palmisano, Emily K. Reinke, Brian E. Richardson, Benjamin N. Rome, Clare E. Safran-Norton, Debra J. Skoniecki, Daniel H. Solomon, Matthew V. Smith, Kurt P. Spindler, Michael J. Stuart, John Wright, Rick W. Wright, Elena Losina. Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. New England Journal of Medicine, 2013; : 130318220107009 DOI:10.1056/NEJMoa1301408

Veterinarian Comments and Reviews

You may find more positive veterinarian comments and reviews around the web. Below are a couple I have copied from various web locations –

“We are so grateful for the expertise and compassion you provide the central/south Texas community!”
Mission Veterinary Specialists, San Antonio, TX

“Once again, thanks for engaging the veterinary industry and client owners with your work and experience. I enjoy your enthusiasm and passion for the area.”
DVM, ACVS (American College of Veterinary Surgeons), South Texas

“Thanks so much, Deborah! The book is impressive. Maybe you should leave a copy at (some shelters) since they put so many cruciate dogs on the euthanasia list…Great work and thank you!”
DVM, Austin, TX

“Read your book. Excellent job. Now at ACVS they are all for non surgical acl (rehab)…Good job!”
DVM, Austin, TX

book cover of my non-surgical recovery booklet

“Finished reading “instead of surgery” kindle booklet. Bueno! Great discussion on importance of pain control, in particular. ”
DVM, Austin, TX

“Hi Deborah! I read your book the night I got it. I really like it and have already recommended it to a client last week. I hope she bought it. I will write a review for amazon for you, too. I hope you are really successful in this. I know how hard you work!”
DVM, Kerrville, TX

“Once again, thanks for engaging the veterinary industry and client owners with your work and experience. I enjoy your enthusiasm and passion for the area.”
DVM, ACVS, South Texas

“Great plan outline! I’ve come to think that using the water treadmill is (overrated), and it’s nice to finally have a definitive plan to get clients on the road to recovery.
DVM, ACVS, Austin, TX

“Just wanted you to know I read and appreciated the CCL rehab book, I will likely keep a few in the clinic.”
DVM, Austin, TX

“Bought one of your books last week. Its great!”
Megan Kelly BVSc DIPVET CCRP Holistic Veterinary Surgeon, Cape Town, South Africa

Please see client reviews and testimonials by clicking on either ^^ word in bold color ^^ 🙂

Thanks! Rehabdeb

(Updated February 10, 2018)

Books for After Surgery: Functional Recovery and Rehabilitation

Has your pet had surgery? Do you need a rehabilitation plan to follow at home?

Then take a moment to look over this site, follow the instructions on the surgery page, and stay calm and thoughtful about your work with your pet.

This book is the program to follow to begin recovery after most orthopedic or neurological surgeries.

Rehabilitation after surgery for torn knee ligament:

Click on THIS LINK, and you should be directed to Amazon in your country, unless you live in these countries – Australia, Brasil, India, Mexico, Nederland , in which case you should click on the name of your country ^^ to be taken to the book.

(available on Kindle and in paperback, and you may order the paperback through any bookseller by using the ISBN 978-0615905358)

Some Reviews About the Books…

(click ^^)

 

Conservative Treatment Books: Instead of or Before Surgery (Pre-hab):

This book is the program to follow to begin recovery for most orthopedic or muscular injuries! This includes hip problems, ankle problems, and others.

Has your pet been injured, and it’s not “life or death”? A torn knee ligament, hip dysplasia, and luxating kneecaps are examples of “not life or death”.

Then take a moment to look over this site, follow the instructions on the “injured” page, and take a deep breath!

This book is the program to follow to begin recovery for most orthopedic or muscular injuries!

Conservative treatment after torn knee ligament, instead of or prior to surgery:

booklet with instructions for you to follow with your dog after injury, instead of surgery or prior to surgery

(click on the THIS LINK, and you should be directed to Amazon in your country, unless you live in these countries –  Australia, Brasil, India, Mexico, Nederland = you should click on the name of your country to be taken to the book).

(available on Kindle and in paperback, and you may order the paperback through any bookseller)

Some Reviews…

A Few Amazon reviews I took time to copy/paste here for you (additional testimonials are above, in the Feedback section):

“I’ve known Deborah Carroll for several years and she has worked with us rehabbing our 90lb Hound/Lab mix. I have always found her to be chock full of great scientific information in rehabbing your pet and the booklet simplifies all that into simple to understand protocol and reasons to follow the protocol to help your dog. Short read but well worth it. I love it!”
D.B., Amazon Review

“The book easily outlines a plan to rehabilitate your dog from a knee injury. I now feel like there is hope for his long term recovery. Thanks Deb!”
Amazon Review

“Using the methods described in this book, we were able to completely rehabilitate our Labrador retriever from a torn ACL without having surgery. Very thankful that this book was so easily accessible!”
H.P., Amazon Review

“I chose not to have my 9 year old Lab put through the stress of surgery on his torn CCL – knowing that he is already showing signs of the other leg being injured. After much research, I found Deborah’s website and read a lot of the blog posts where I learned of her book. I have been using the therapy in the book now for about a month and it is working well in conjunction with some holistic remedies and massage, Since the process of healing is really the same for both non-surgery and surgery dogs, this book will help either way! Easy to follow, but you do have to stick with it to see results.”
Amazon Review

“I have worked in a variety of animal care fields – as a veterinary technician, pet sitter, and behavior consultant – since 1997, and have several mutual clients with the author. As such, I have seen first-hand what she can do for both her clients and patients. Her knowledge, skill, and bedside manner are impeccable, to the point that she has become the only person that I refer people to for small animal rehabilitation in the Austin area. I am so glad that she has written this book, so that people who live outside the Austin area can benefit from her expertise. I highly recommend it!”
Emily S., Amazon Review, From Beaks to Barks

“This was an easy to read and understand guidebook. There were lots of practical tips offered. Her program is something I can follow on a day to day basis. The author has obviously had lots of experience with dog rehabilitation and wants the best for our dogs.”
Lori L., Amazon Review

“I love Deborah Carroll and her approaches to rehab/conditioning- we see her next week.”
Courtney K, Austin, TX Courtney’s Agility Page

Dobi the Doberman-Lab Mix with Torn Knee Ligament (CCL Tear, CCR) & Bad Hips

Testimony of Doberman Rehabilitation –

Tricia’s Thoughts –

“Our old Lab-Doberman mix blew out his knee darting after a squirrel and only narrowly avoided surgery since he had a small amount of stability left.

I reached out to Deb, and I’m so glad I did. Her plan was honestly a lot of work, but it paid off beautifully. Our pup got better than I ever thought possible and even came out of the whole experience with super muscular dog legs!

I love that Deb comes right to your house and works with you in your own environment. A lot of the time we’d look around the house or neighborhood to find good places or items to make drills out of. She’s extremely knowledgeable and worked well with our vet to get him (Dobi) on the right medications and dosages.

On top of it all, you can tell she genuinely cares. That goes a long way with me.

I highly recommend her services for your own busted up dog!”
Tricia E. Austin, TX , Oct. 1, 2016)

(^^Copied from Yelp Review)

Nick’s Thoughts –

Dobi Cavalettis for Rehab Work After 4 Week Intro Program Complete. Other Cavaletti Photos are Under the Photos Section or You May Find Them by Searching Cavalettis.

“When our 10-year-old lab mix busted his knee, he was in rough shape and only narrowly avoided surgery. Luckily, we found Deb and got the opportunity to work with her in person.

She had us read her book before our first meeting. The book itself is in invaluable. It’s a short read, but it lays out a basic plan with lots of explanation and support for each technique. The combined force of the book and Deb’s physical therapy sessions healed our pup more than we thought possible, especially given his age. The program does take work, but the results really are extraordinary.

Whether you can work with Deb in person or not, this book is a must if you have a dog in recovery.”

Nick E., Oct. 1, 2016

(^^Copied from Amazon review)

Rehab Deb’s Thoughts 5/26/17

Dobi’s mom, Trish, found me via this (my) website and reached out to me Dec. 1, 2014.

Trish and Nick performed the work I recommended, and Dobi has maintained very good function through the past couple of years, despite some other health issues. Dobi was almost 10 years old when I met him, and in the past year Trish has reached out to me to confirm with me where to return to in the recovery program after Dobi’s ongoing internal medicine issues were being diagnosed and treated.

Please click on the link below to see a short video of Dobi walking after slightly less than two months of work:

2015 3-17 Dobi Short Indoor Walk Improved

Once a pet caretaker, partner, “parent” works through the program as I have recommended it and everyone has seen the positive results, the same program may be returned to over the years as new injuries or illnesses occur. Sometimes there are new medical or physical situations that require a different protocol than the one I originally recommended. In Dobi’s case, his program could stay almost the same and used toward recovery after new diagnoses.

Rehabdeb, May 26, 2017

Updated with new photos March 28, 2018