Dry Needling and Quad Strength After Anterior Cruciate Ligament Reconstructon (ACLR)

Effects of Dry Needling on Quadriceps Muscle Strength in Acute Post-Operative Anterior Cruciate Ligament Reconstruction With Quadriceps Autograft in the Pediatric Population.

Dry needling is a skilled intervention provided by trained physical therapists to treat pain, myofascial dysfunction, and a variety of other diagnosis. While there is research demonstrating the benefits of dry needling in reduction of pain and improvement in strength, research in regards the pediatric population is very limited. I recently completed a retrospective chart review regarding dry needling trends and outcomes in the pediatric orthopedic population. We now know the pediatric population is tolerating this treatment and seeing benefits. Physical therapists are already pushing the boundaries and finding additional benefits in the use of dry needling with our current patients. A diagnosis frequently seen in sports medicine is surgical reconstruction of the anterior cruciate ligament (ACL). Over the last couple of years, therapists have seen an increase in the use of quadriceps tendon autograft for reconstruction following ACL tears due to lower incidence rate of retears. These patients have been struggling to regain strength of the quadriceps to meet desired outcomes. The quadricep muscles are one of the major stabilizers of the knee and with a reduction in strength places the patient at a significant increase of retear.

Subjects will be categorized into an experimental group (dry needling intervention + physical therapy) or the control group (physical therapy only) with a N of 20 in each group.

The goal for this research is to determine if dry needling use in the subacute phase of post-operative ACLR following quadriceps autograft can assist with increasing quad strength and improve post-surgical outcomes.

Study Overview

• Status: Not yet recruiting
• Conditions: Dry Needling; Strength; Anterior Cruciate Ligament Reconstruction Rehabilitation
• Intervention / Treatment: Procedure: Dry Needling

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mellony J Mann, DPT; Phone Number: 913- 717-4750; Email: mjmann@cmh.edu
• Study Contact Backup: Name: Shannon R Margherio, PT; Phone Number: 816-816-6927; Email: srmargherio@cmh.edu

Study Locations

• United States
  • Kansas
    • Kansas City, Kansas, United States, 66111
      • Children's Mercy Sports Medicine Center- Village West
      • Contact: Mellony R. Mann, DPT; Phone Number: (913) 717-4750; Email: mjmann@cmh.edu
      • Contact: Shannon Margherio, PT; Phone Number: 816-816-6927; Email: srmargherio@cmh.edu
    • Overland Park, Kansas, United States, 66223
      • Children's Mercy - Blue Valley
      • Contact: Mellony R. Mann, DPT; Phone Number: (913) 717-4750; Email: mjmann@cmh.edu
      • Contact: Shannon Margherio, PT; Phone Number: 816-816-6927; Email: srmargherio@cmh.edu
  • Missouri
    • Kansas City, Missouri, United States, 64108
      • Children's Mercy Hospital- Kansas City
      • Contact: Mellony R. Mann, DPT; Phone Number: (913) 717-4750; Email: mjmann@cmh.edu
      • Contact: Shannon Margherio, PT; Phone Number: 816-816-6927; Email: srmargherio@cmh.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Status post subacute quadriceps autograft 6 weeks or less
• Ages 10-20 years
• English and/or Spanish speaking

Exclusion Criteria:

• History of surgery on the knee or hip on the testing lower extremity.
• Any surgical intervention to other ligamentous or meniscus structures during time of ACLR
• Any post-surgical complications such as infection
• Current pregnancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dry Needling Group; For the Intervention Group, dry needling will be completed to the quadriceps muscle. Strength measurements will be taken using a handheld dynamometer in post-operative weeks 6, 7, and 9.	Procedure: Dry Needling; Dry needling is defined as a skilled intervention that utilizes a thin filiform needle to stimulate underlying myofascial trigger points, muscular, and connective tissue in managing pain and movement dysfunction. For the Intervention Group, dry needling will be completed to the quadriceps as stated below. Two sessions of dry needling will be done once per week starting in week 6 and finishing by end of week 7. The patient will be laying in supine. Needles will be placed in the quadriceps muscle. Placement will be at identified trigger points or in mid muscle belly if no trigger point is identified. Electrical stimulation will be applied and increased to an intensity of the patient's tolerance with a visual contraction noted. Electrical stimulation will remain on for 5 minutes.
No Intervention: Control Group (No dry needling); Participants will not receive dry needling intervention. Strength measurements will be taken using a handheld dynamometer in post-operative weeks 6, 7, and 9.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Quadriceps Muscle Strength	Muscle strength measurement will be taken with use of the handheld dynamometer and use of stabilizing gait belt. A max force production will be created over three seconds. Three trials will be recorded, and average will be used as the final number. For the intervention group, measurements will be taken immediately prior to dry needling and immediately following dry needling for both sessions of intervention (week 6 and week 7). Additional post intervention measurements will be taken 2 weeks following dry needling intervention (week 9). For the Control Group, measurements will be taken during week 6, week 7, and week 9. Measurements will be taken at the start of the physical therapy visit.	Muscle strength measurements taken at post-operative week 6, 7, and 9.

Collaborators and Investigators

• Sponsor: Children's Mercy Hospital Kansas City
• Investigators: Principal Investigator: Mellony J Mann, DPT, Children's Mercy Hospital Kansas City

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): June 30, 2027
• Study Completion (Estimated): June 30, 2027

Study Registration Dates

• First Submitted: June 15, 2026
• First Submitted That Met QC Criteria: June 15, 2026
• First Posted (Actual): June 18, 2026

Study Record Updates

• Last Update Posted (Actual): June 18, 2026
• Last Update Submitted That Met QC Criteria: June 15, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Therapeutics; Complementary Therapies; Physical Therapy Modalities; Dry Needling
• Other Study ID Numbers: STUDY00003889

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No