Joint Replacements in an outpatient PT clinic.

[Robert Curtner]

I am a physical therapist working in a private practice setting, seeing a lot of post-op joint replacements (knee, hip, and shoulders). What special considerations/contraindications should I account for when implementing needling in these patients? My primary goal would be to affect the joint capsule to improve range of motion. Thanks in advance!

Robert Curtner, PT, DPT

[Susan Falsone]

Hey Robert-

Any time there is a joint replacement, I would be very cautious with needling the actual joint. I would make sure the MD is on board, patient understands the risk (a few case reports of infection and needed revisions in hip patients. These are usually case studies but there is still some evidence.).

If the doc feels like it is helpful, patient is willing to accept the risk and you decide to proceed, I would take extra caution for clean technique, including cleaning the skin and possible use of sterile gloves.

Risk is lowered if you stay away from the joint and focus on surrounding musculature which may be helpful as well, while lowering your overall risk.

Hope that is helpful! Sorry for the delay here! Some back end computer issues so just seeing this!

All the best-
Sue

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