Mohammad E Tamboosi* and Hashim T Alharthi

National Guard Hospital, King Abdullah International Medical Research Center, Jeddah, Kingdome of Saudi Arabia

*Corresponding Author: Mohammad E Tamboosi, National Guard Hospital, King Abdullah International Medical Research Center, Jeddah, Kingdome of Saudi Arabia.

Received: April 18, 2022; Published: May 09, 2022

Abstract

Background: Complications during elbow joint (EJ) injuries might indicate further surgeries such as Total Elbow Arthroplasty (TEA), which is rarely performed from an expert surgeons. Furthermore, there are many complications occur after TEA such as infection, implant loosening, instability, fracture, and component failure in the form of bushing wear. Additionally, the triceps complications occur after the surgery. Also, the Range of Motion (ROM) of the elbow extension will be limited. Yet, there is no evidence proof the effectiveness of DN on TEA.

Objective: The current study aimed to investigate the effectiveness of DN for post TEA to Improve Range of Motion (ROM), Upper Extremity Dexterity and Functions.

Case Description: This case is a male patient, 32-years old, post TEA, 6 months post operation. He had motor vehicle accident (MVA), fixed externally 6 years ago. Multiple irrigation and debridement were performed after the accident. Finally, the physician decided to perform TEA for him, referred to physiotherapy after the operation to start the rehabilitation program which included strengthening exercises and ROM exercises. Visited our clinic to continue the rehabilitation program. During the examination, the ROM was limited and the muscles, especially the triceps, were weak.

Intervention: Patient continued the same rehabilitation program (ROM and muscles strengthening), DN was added to the intervention. He was seen for 3 times per week, for 8 weeks. DN was be applied once per week.

Results: There was a significant improvement in Box and Blocks (BBT) and Disabilities of the Arm, Shoulder, and Hand (DASH), but there was no significant difference in ROM.

Conclusion: Applying DN on post TEA demonstrate a significant improvement in dexterity and performance of EJ. Patient must continue rehabilitation program daily and the DN should be applied around the scar and on the TrPs for at least once every 2 weeks to observe the improvement.

Keywords: Total Elbow Arthroplasty; TEA; Dry Needling; Elbow; Rehabilitation

References

1. A Prkić B and D Eygendaal. “Total Elbow Arthroplasty: The State of Clinical Practice”. Medscape (2016): 1-7.
2. V Samdanis., et al. “Indications and outcome in total elbow arthroplasty: A systematic review”. Shoulder Elbow (2019): 1-9.
3. J Sanchez-sotelo. “Total Elbow Arthroplasty”. The Open Orthopaedics Journal (2011): 115-123.
4. H Chen., et al. “Replacement or repair of terrible triad of the elbow”. Medicine (Baltimore) (2019): 1-
5. SK Kunutsor., et al. “Incidence, temporal trends and potential risk factors for prosthetic joint infection after primary total shoulder and elbow replacement: Systematic review and meta-analysis ✩”. Journal of Infection 4 (2020): 426-436.
6. RW Wysocki and MS Cohen. “Management of Periprosthetic Joint”. Journal of Hand Surgery (American Volume) 10 (2020): 957-970.
7. MR Claxton., et al. “Humeral amputation following total elbow arthroplasty”. International Orthopaedics (2021): 1281-
8. MK Solarz., et al. “A Clinical Comparison of Triceps-Sparing and Triceps-Detaching Approaches for Revision Total Elbow Arthroplasty”. Journal of Hand Surgery (American Volume) (2019): 1-6.
9. JA Strelzow., et al. “Management of rheumatoid arthritis of the elbow with a convertible total elbow arthroplasty”. Journal of Shoulder and Elbow Surgery 11 (2019): 2205-2214.
10. M , et al. “Rehabilitation of elbow fractures and dislocations” (2017).
11. AL Wolff. “Postoperative Management After Total Elbow Replacement”. Techniques in Hand and Upper Extremity Surgery3 (2020): 213-220.
12. H Huang., et al. “Opposing needling for analgesia and rehabilitation after unilateral total knee arthroplasty: a randomized, sham- controlled trial protocol” (2020): 1-10.
13. C Romero-morales and C Calvo-lobo. “Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture”. Medicine (Baltimore) 17 (2017).
14. R Halle., et al. “DRY NEEDLING AND PHYSICAL THERAPY VERSUS PHYSICAL THERAPY ALONE FOLLOWING SHOULDER STABILIZATION REPAIR”. International Journal of Sports Physical Therapy1 (2020): 81-102.
15. DE Beaton., et al. “Measuring the Whole or the Parts? Validity Reliability, and Responsiveness of the Disabilities of the Arm, Shoulder and Hand Outcome Measure in Different Regions of the Upper Extremity”. Journal of Hand Therapy2 (2001): 128-146.
16. C , et al. “The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: Longitudinal construct validity and measuring self-rated health change after surgery”. BMC Musculoskeletal Disorders 4 (2003): 1-6.
17. J Dewosiers., et al. “Validation of the Box and Block Test as a Measure of Dexterity of Elderly People: Reliability, Validity, and Norms Studies”. Archives of Physical Medicine and Rehabilitation 75 (1994): 751-755.
18. A Prkić., et al. “Total elbow arthroplasty is moving forward: Review on past, present and future”. World Journal of Orthopedics 1 (2016): 44-49.
19. NJ Forget and J Higgins. “Comparison of generic patient-reported outcome measures used with upper extremity musculoskeletal disorders: Linking process using the International Classification of Functioning, Disability, and Health (ICF)”. Journal of Rehabilitation Medicine 4 (2014): 327-334.

Citation

Citation: Mohammad E Tamboosi and Hashim T Alharthi. “The Effectiveness of Dry Needling on Total Elbow Arthroplasty to Improve Range of Motion, Upper Extremity Dexterity and Performance: Case Report".Acta Scientific Orthopaedics 5.6 (2022): 22-27.

Copyright

Copyright: © 2022 Mohammad E Tamboosi and Hashim T Alharthi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.