Manipulation Under Anesthesia After Total Knee Replacement

Manipulation Under Anesthesia After Total Knee Replacement

Total knee replacement is a surgery for end-stage knee arthritis that reduces pain and increases function. It is a non-surgical procedure performed in hospitals or clinics under general anesthesia.

Most patients make steady progress in strength and range of motion of the knee after surgery, but some may experience stiffness and pain afterward.

What Is a Manipulation Under Anesthesia

Manipulation under anesthesia (MUA) is a procedure used to improve the range of motion (ROM) of the knee after total knee replacement (TKR).

In this, general anesthesia is used due to which you become unconscious. This is done so that you do not feel any pain while correcting your knee.
During MUA, your surgeon will gently bend and straighten your knee to break up scar tissue and adhesions that may be limiting your movement.

Why is MUA done?

MUA is typically performed when someone experiences stiffness after TKR that does not improve with other treatments such as physical therapy. Stiffness after TKR can be caused by a variety of factors, including scar tissue formation, adhesions, and muscle stiffness.
There are certain patients for whom MUA may not be recommended. Those who have the following should have the procedure with caution:
  1. Osteoporosis
  2. Cancer
  3. Cardiovascular Disease
  4. Flaring Inflammatory Arthritis
  5. Bone Fracture(s)
  6. Staph or Strep infection
  7. Uncontrolled Diabetes
  8. Uncontrolled Hypertension

Manipulation Under Anesthesia Procedure

Friends, above we understood what Manipulation Under Anesthesia is and why it is done. Now we understand the process of Manipulation Under Anesthesia.
A manipulation uses specific maneuvers and physical techniques to break down fibrous adhesions around the joint and surrounding tissues.
But you don’t feel anything during the procedure.
you are completely unaware of what is happening because of the anesthesia.
During MUA after knee replacement, you lie on your back and your hip is bent 90 degrees.
Holding your leg near the knee joint, steady progressive pressure is applied until your surgeon hears and feels your adhesion breaking.
The knee is kept in this position for 20 to 30 seconds. Then it is raised to the maximum position by rotating it several times.

Timing of a Manipulation Under Anesthesia

Timing is of the essence for Manipulation Under Anesthesia (MUA). Studies indicate that the best results are achieved when MUA is performed within 3 months of surgery.
Your doctor may assess your range of motion in about 3 months to decide whether an MUA is necessary.
While possible after 3 months, results may be less predictable. In such cases, additional testing or arthroscopic surgery may be recommended to relieve stiffness.

What Are The Risks And Benefits of MUA?

You have read what MUA is and why it is done. After reading this, this question might come to your mind what are the advantages and disadvantages of MUA? Moves Now let’s talk about the risks and benefits of MUA.

Risks of a Manipulation Under Anesthesia

Most patients experience increased knee mobility and decreased pain after the procedure, but there are some potential risks:

Benefits of a Manipulation Under Anesthesia

MUA is Not Always Successful

MUA, although often effective in improving range of motion, may not always be successful. Muscle pain is common after the procedure, but significant improvement is expected within a few weeks, especially in cases of muscle adhesions.
However, 25% of patients may require a second MUA for knee stiffness. Some surgeons avoid MUA altogether, doubting its effectiveness.

How To Avoid Manipulation Under Anesthesia

We know the MUA process is very risky. Therefore, very very people want to avoid this process. If you are one of them, the best way to avoid MUA is to do exercises as directed by your doctor or physical therapist.
Consistent exercise can prevent scar tissue from sticking to the inside of your knee. Once these adhesions form, they are very difficult to break down on your own, and you may need manipulation to regain your motion.

What To Expect After MUA?

After a MUA, your knee will likely be sore and swollen for a few days. You will need to use crutches or a walker for a short time and attend physical therapy to help regain your strength and range of motion.

FAQs About MUA

The duration of the MUA procedure may vary depending on the individual case and the extent of manipulation required. On average, the procedure lasts between 15 minutes to an hour.
Although some discomfort may be experienced during the procedure, patients are under anesthesia and usually do not feel pain. However, pain and discomfort are common after the procedure and can be managed with painkillers prescribed by your healthcare provider.
The success rates of MUA vary among patients, but are generally high, with many individuals experiencing significant improvements in knee function and mobility after the procedure.
Long-term complications from MUA after total knee replacement are rare. However, it is essential to carefully follow post-operative care instructions to minimize the risk of complications and ensure optimal results.
In some cases, patients may require multiple MUA procedures to achieve the desired level of improvement in knee mobility. However, this decision is made on a case-by-case basis, taking into account the individual’s overall health and response to previous treatments.
During the recovery period, patients can expect to gradually regain mobility and functionality in their knee joint. Physical therapy and rehabilitation exercises play an important role in maximizing the benefits of MUA and promoting long-term recovery.

Conclusion: Manipulation under anesthesia

Manipulation under anesthesia after total knee replacement is a valuable option for patients experiencing stiffness or limited mobility after TKR surgery.
By breaking down scar tissue and adhesions, MUA can help restore optimal function of the knee joint, improving patients’ overall quality of life.
Although it is important to consider the risks associated with it and the recovery process, many individuals experience significant benefits from the procedure.