Should Physicians Write Articles About Rehabilitation?


I always try to stay on top of recent research, both for my own clinical skills but also for my physical therapy blog.  I will use this blog to post some of the latest and greatest with some clinical implications, but this post is almost the reverse!  I was reading through the current issue of the journal Techniques in Orthopaedics today and found an article that perked my interest, entitled Rehabilitation After Patellar Tendon Autograft Anterior Cruciate Ligament Reconstruction.  As I started to read the article, I glanced at the authors and noticed it was written by two orthopedic surgeons, no physical therapist or other rehabilitation specialist was listed.  The abstract wasn’t bad:

Rehabilitation protocols after bone-patellar tendon-bone anterior cruciate ligament reconstruction have become significantly more aggressive over the past decade. Key concepts of an accelerated rehabilitation protocol include immediate full weight bearing, unrestricted range of motion, early closed kinetic exercises, and return to play by 4 months. Additional components of a successful rehabilitation program include appropriate timing of surgery, adequate postoperative analgesia, use of cryotherapy, and diligent surveillance for the development of postoperative motion complications. In addition to thorough patient evaluation and meticulous surgical technique, a comprehensive rehabilitation protocol for the reconstructed knee is an essential part of the overall treatment algorithm of the anterior cruciate ligament injured extremity. This article reviews a variety of different factors involved in successful rehabilitation after anterior cruciate reconstruction using patellar bone-tendon-bone autograft and presents a comprehensive rehabilitation protocol.

I have to admit, though, I stopped reading it.  I am not sure how I feel about an article about rehabilitation that is written by orthopedic surgeons with no collaboration from a physical therapist.  I realize that the journal is an orthopedic surgery technique journal, but I was reading it so there must be more people like me that are not surgeons that at least glance at the table of contents.  If you use my website that automatically collects all the new table of contents of orthopedic journals than you may have read it too!
Don’t get my wrong, I know the authors are excellent surgeons and respect their work.  They are , credible but I wonder if we are doing the rehabilitation justice if the authors do not actually conduct the rehabilitation.  How do they know the day-to-day intricacies of the rehabilitation progression? 

Does anyone else agree?

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3 Responses to “Should Physicians Write Articles About Rehabilitation?”

  1. Travis Manners, PT, SCS, CSCS Reply October 28, 2008 at 10:53 am

    Mike,

    I guess I will comment first. I agree with you 100%. I would not have kept reading the article as you did. To me, if they are not including a rehab person in their group to generate this article they are missing the boat and further hindering our field from being understood fully by the orthopedists. How often have you written chapters or articles on rehab and when discussing the specific surgerical approaches did you consulted Dr Andrews or someone else who does surgery for a profession? Not very often would be my guess. I am not sure which MDs wrote this article and repected or not, they did not do their due diligence in putting together a complete paper. Did they list an email contact? Would be nice if someone shot them an email guarding this concern.

    Great post.

  2. I am always most impressed with surgeons that give credit to rehab. Dr. Andrews was always good at this, saying “my job is easy, the hard part is the therapy.” I hope they at least collaborated with their staff PTs, but bummer that they didn’t do them the honor of including their names as authors!

  3. I too hope they collaborated with their PTs and if they did, I hope the PTs stand up for themselves and work they did to those MDs. Without getting on a soap box, to often it seems PTs are not willing to approach physicians with things they disagree about whether it is something like this or patient care.

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