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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 694941, 8 pages
Research Article

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

1Physical Therapy Unit, Hospital Provincial de Toledo, Cerro de San Servando s/n, 45006 Toledo, Spain
2Unit of Physiotherapy, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Rovira i Virgili University, Carrer Sant Llorenç 21, 43201 Reus, Spain
3Orthopedic Surgery Service, Hospital Provincial de Toledo, Cerro de San Servando s/n, 45006 Toledo, Spain

Received 31 December 2012; Revised 25 February 2013; Accepted 27 February 2013

Academic Editor: Chang-Zern Hong

Copyright © 2013 Orlando Mayoral et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.