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A comparison of dry needle placement accuracy rates between two approaches targeting the gluteus medius
Bryan Dinh1,2, James Dunning2,3, Gary A Kearns4
1School of Physical Therapy, Langston University, Langston, Oklahoma, USA.
Objective:
The purpose of this study was to compare the accuracy of two dry needling (DN) techniques in embalmed cadavers that are commonly used to target the gluteus medius osteotendinous junction (OTJ).
Methods:
Seven embalmed cadaveric specimens were placed in prone. Technique 1 used a needle insertion point that was measured 2 fingerbreadths superior and 3 fingerbreadths posteromedial to the greater trochanter (GT) apex using the donor's fingerbreadths. The needle insertion point for technique 2 involved locating a line between the GT apex and the sacro-coccygeal hiatus and estimating one-third of the distance from the GT. Using the entry point for each technique, a dry needle was then inserted in each body with an anterior and inferolateral angulation until contact with a boney backdrop was achieved. Dissections of the posterior hip muscles were then performed to confirm with a binary decision (yes/no) the needle tip location at the gluteus medius OTJ.
Results:
In embalmed cadavers, the accuracy rate of the needle tip reaching the gluteus medius OTJ using Technique 1 (9 out of 10, 90%) was significantly higher (chi-squared test with Yates' correction = 9.800; p = 0.0017) than Technique 2 (1 out of 10, 10%).
Discussion/Conclusion:
Surface palpation of bony landmarks and a direction-specific fingerbreadth measurement is an appropriate method to locate the correct needle insertion point superomedial to the greater trochanter to reach the gluteus medius OTJ with a 90% accuracy rate.
