Efficacy of Myofascial Trigger Point Dry Needling in the Prevention of Pain after Total Knee Arthroplasty: A Randomized, Double-Blinded, Placebo-Controlled Trial

Abstract

The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4–5 hours before surgery. Immediately following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when pain was the most severe. Results show a superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented.

Physiotherapy with and without Superficial Dry Needling Affects Pain and Muscle Strength in Patients with Patellofemoral Pain Syndrome

“…The result of the present study was consistent with the results derived from the research by Orlando Mayoral and colleagues in 2013 on patients with knee arthroplasty [29]. In 2007, Sierre Adam and colleagues did their research on two treatment groups (Chiropractic-Chiropractic and DN) in patients with patellofemoral pain syndrome.…”

“…Orlando Mayoral and colleagues in 2013 applied the DN technique in patients with knee arthroplasty. They found that the maximum of isometric muscle strength in the intervention group was similar to placebo group after treatment [29]. In 2009, Adam Sayers investigated the effect of DN on the vastus medialis muscle in patients with patella femoral pain syndrome.…”

The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

“…After the full review process, 12 studies were selected for inclusion. 2,7,12,24,27,28,32,33,35,36,38,43 After contact with primary authors of included studies, 1 further study was identified for inclusion, 6 resulting in a total of 13 studies. The absolute degree of rater agreement for the first and second stages of the study selection was 86% and 93%, respectively.…”

“…This systematic review focused on musculoskeletal pain and included 13 studies: 6 on neck pain (5 on mechanical neck pain 6,24,28,32,43 and 1 on chronic whiplash-associated disorder 38 ), 1 on postoperative shoulder pain, 2 1 on chronic lower back pain, 33 1 on total knee arthroplasty, 27 1 on chronic ankle instability, 35 2 on myofascial pain, 12,36 and 1 on fibromyalgia. 7 Inclusion and exclusion criteria varied greatly across the studies.…”

Effectiveness of Inclusion of Dry Needling in a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial

“…22 Similarly, a recent review concluded that TrP DN was effective for lower-quarter pain syndromes in the short term; however, its effects on function have been questioned. 29 Some studies included in this review support the use of TrP DN of the knee musculature for knee osteoarthritis 19 or after knee replacement 28 ; however, no study has previously investigated the effect of TrP DN in patients with PFP. Therefore, the objective of this study was to compare the effects of adding TrP DN to a manual therapy and exercise program on pain, function, and disability in people with PFP.…”