1. I would be focused on needling into all the areas that are swollen with .15mm needles as discussed in foundations courses. That is more than likely heavily preventing most end range motion. I would also encourage you to include the majority of the lower leg homestatic points: ITB, saphenous point, common fibular and tibial point as they all share some functions of the lower leg which contribute to tib fib mobility as well as the screw home mechanism (either directly or indirectly) especially when referencing CKC flexion/extension. I would also encourage you to needle into the ITB as it’s often a restrictor of both end range flexion and knee extension. 

for me, my #1 priority would be to eliminate swelling and using neural points to help modulate inflammation in that limb. I would go back to the lumbar spine for segments that innervate the knee (L3/L4 primarily) and then use homeostatics of the limb. As well as many little needles in the pockets of swelling— even a little bit of visual swelling can be highly compromising especially 4 months post operatively. This also begs the question what is the rehab looking like when you are not the provider? Is it too aggressive? Is it not preparing her for her ADLs, or should she be sent back to her physician to look again at the joint as to why she is still swollen?