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Common Fibular homeostatic neurotrigger point s/p knee replacement

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Posts: 2
 Dan
Customer
Topic starter
Member
Joined: 6 months ago

I have a patient who is about 6 weeks post op from a TKR who has achieved all of his ROM and strength goals and is mostly pain free with the exception of constant residual lateral and inferior knee pain that is exacerbated when palpating the common fibular homeostatic on the surgical side.  I have a strong degree of suspicion that needling this area will provide this patient relief.  I want to know if 6 weeks post op is long enough of a wait time to do this and if the common fibular is close enough to where I should get clearance from the surgeon.  Thanks.

 

 

 

 

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Customer
Joined: 3 years ago

Member
Posts: 1

Hey Dan! I think needling the common fib would be a great idea for this patient! 

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Posts: 4
 Nina
Instructor
Joined: 5 years ago

Dan,

 

I agree with you and Jenna, it would be an EXCELLENT location to needle for this patient, and likely very productive for symptom modification. To answer all aspects of your question—

 

when in doubt, it’s always best to ask the surgeon you work with what boundaries he has regarding dry needling if any (more specifically in regards to intra-articular needle points vs. surrounding/supporting structures) .

*Most of the time* I have heard somewhere between 6 weeks-3 months is the response of most surgeons when it comes to needling into the joint space that was operated on (some very strict ones may even say never).

 

In this case of a TKR, the common fibular needle point would not go into the joint space itself, so the surgeon may be even more lenient on time frame for locations like this or even other supporting structures like the quadriceps, hamstrings, gastroc etc. In terms of healing and patient safety, 6 weeks is plenty long enough wait time. I have needled surrounding structures like this far earlier post operatively (with the green light from surgeons).

 

Again, it’s always best to have open communication with surgeons to get their opinions on what they are comfortable with, especially if you hope to maintain a good relationship with them. I have worked with a variety of different surgeons who have had varying degrees of strictness regarding the post-operative phases.  

hope this helps!

Nina

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Posts: 2
 Dan
Customer
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Joined: 6 months ago

Thank you all for the insight!

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