Periosteal Electrical Dry Needling for Knee Osteoarthritis

Alabama Physical Therapy & Acupuncture

Status: Completed

Conditions: Knee Osteoarthritis

Treatments: Other: periosteal electrical dry needling with maintenance treatments every other month; Other: periosteal electrical dry needling with no maintenance treatments; Other: periosteal electrical dry needling with monthly maintenance treatments

Study type: Interventional

Funder types: Other

Identifiers

NCT05365061

AAMT20231

Details and patient eligibility

About

The purpose of this research is to treat patients with knee osteoarthritis (OA) with periosteal electric dry needling (PEDN). It is also to determine the optimal "maintenance" regiment (i.e. maintenance treatments, one maintenance treatment every other month, or one maintenance treatment per month) required to maintain improvements in pain and function following PEDN. Physical therapists commonly use PEDN to treat knee OA, and previous studies suggest that this treatment is useful for reducing pain and improving function in patients with osteoarthritis. However, an appropriate maintenance treatment strategy to maintain these outcomes is presently unknown.

Full description

Patients with knee osteoarthritis will be randomized to receive periosteal electrical dry needling 1-2 treatments per week for 6 weeks (up to 10 sessions total) followed by either: 1. no maintenance treatments, 2. one maintenance treatment every other month or 3. one maintenance treatment per month.

Enrollment: 586 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Adult over the age of 18 years old:

2. Report of knee pain of at least 2/10 per NPRS (0---10 scale) for >3 months

3. Report of at least 3 of the following per Altman et al. (1986) (sensitivity = 95% / specificity = 69%)

   1. Over 50 Years of age
   2. Less than 30 minutes of morning stiffness
   3. Crepitus on active motion
   4. Bony tenderness
   5. Bony enlargement
   6. No palpable warmth of Synovium

Exclusion criteria

1. Report of red flags to manual physical therapy to include: hypertension, infection, diabetes, peripheral neuropathy, heart disease, stroke, chronic ischemia, edema, severe varicosities, tumor, metabolic disease, prolonged steroid use, fracture, RA, osteoporosis, severe vascular disease, malignancy, etc.

2. History of physical therapy, massage therapy, chiropractic treatment, or injections for knee pain in last 4 weeks.

3. History of a partial or total knee replacement on the painful lower extremity.

4. History of a surgical procedure on either lower extremity in last 12 months.

5. Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:

   1. Weakness involving a major muscle group of the lower extremity.
   2. Diminished patella or achilles tendon reflex
   3. Diminished or absent sensation to pinprick in lower extremity dermatome.

6. Involvement in litigation or worker's compensation regarding knee pain.

7. Any condition that might contraindicate the use of periosteal electric dry needling

8. The patient is pregnant.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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586 participants in 3 patient groups

Periosteal electrical dry needling followed by no maintenance treatments

Experimental group

Description:

Periosteal electrical dry needling followed by no maintenance treatments

Treatment:

Other: periosteal electrical dry needling with no maintenance treatments

Periosteal electrical dry needling followed by maintenance treatments every other month

Active Comparator group

Description:

Periosteal electrical dry needling followed by maintenance treatments every other month

Treatment:

Other: periosteal electrical dry needling with maintenance treatments every other month

Periosteal electrical dry needling followed by monthly maintenance treatments

Active Comparator group

Description:

Periosteal electrical dry needling followed by monthly maintenance treatments

Treatment:

Other: periosteal electrical dry needling with monthly maintenance treatments