Just had MUA 9 weeks post TKR

Posted , 6 users are following.

I hit a plateau at about 6 weeks post TKR and last week, at 8 weeks, my surgeon recommended an MUA, which I had yesterday. I was very excited when he told me he had gotten me to 135 degrees on the table and even showed me a picture of my heel right up against my butt!

I felt like my bend would really be able to improve, as I no longer felt restricted at the front of the knee, where all the scar tissue was, although my thigh is very sore from the manipulation and that is what is now keeping me from bending.

BUT... today I went for my first post-MUA physical therapy and measured at ... exactly the same 95 degrees where I had plateaued. Moreover, when I told my PT that my surgeon wanted me to continue to come for therapy 5 days a week until I reached 125, she was dismissive, saying that the surgeons tend to be more optimistic than realistic and she doubted I could get that far. Also, he was very clear that he wanted me to do only land therapy for the first two weeks rather than aqua therapy, because I would progress more that way, whereas she said she thought aqua therapy would be more helpful to me as it would allow me greater range of motion. I am in tears now and very depressed. I knew I woudn't be going in today at the 135 he got me to on the table, but I'd thought I would have made at least some progress. And the PT's comments undermining my surgeon's advice were also difficult to take. I feel that I have to follow the surgeon's advice rather than the PT's but overall I'm very discouraged. Any words of advice or encouragement would be greatly appreciated.

BTW ... I do have to say that I found the MUA itself pretty much as advertised. I woke up in the recovery room (anesthesia was light sedation) in a lot of pain but it actually subsided pretty quickly. I left the hospital within 3 hours, pain well managed with Norco 5/325, and I had a good night. Even planning to go back to work day after tomorrow!

0 likes, 15 replies

Report / Delete

15 Replies

  • Posted

    Judy,

    Do not get discouraged it will just keep getting better with time and hard work. Keep pushing yourself to get your knee to bend, it takes a lot of time. If they made it bend to 135 then you know it is possible.

    Report / Delete Reply
  • Posted

    Hi Judi-

    I was in the same situation. I am now 14 months post RTKR. Had the MUA 4 months post TKR. My doctor also showed me pictures of my knee bent fully. I did have horrific pain afterwards though. I found a very good physical therapist and went 6 days a week for three weeks and finally got over the hump and have about 130 degrees now. It was gradual though and if you don't keep it moving the scar tissue will come right back. I would suggest you find a new therapist. Hang in there and just keep working at it. Hope it all goes well!

    Report / Delete Reply
    • Posted

      Thanks for the encouragement! My pain now is actually pretty good; really only feel like I have to take the Norco before PT, My husband said the same thing when I got home yesterday in tears--find a new PT--but it's actually not that straightforward, when this practice has been really good about accommodating my need for the daily sessions and fitting me in. (Actually I have a long "rap sheet" with them from previous hip strain, rotator cuff impingement, and two meniscus tears!) I am seeing a different member of the practice today and will see how she does. Also ... somewhat calmer in the light of day ... may even say something to the first PT about how I need her to be more positive for me and compliant with my doctor's orders. BUT ... I would love to hear more stories of success after MUA and any tips people have! I do need all the encouragement I can get right now. Off in a moment to "aqua arthritis" class in the bath-water-temp heated pool--I'm thinking that will help!

      Report / Delete Reply
    • Posted

      Could I ask you where you

      Iive only because I have had no encouragement from the physio I saw after my tnr. I haven't heard of anqu to help me. I am having trouble bending my knee it is at 90 deg . Susan

      Report / Delete Reply
    • Posted

      I live in Maryland, US. Again, that is one thing I really like about my current PT practice: they have both land and water therapy. The aqua therapy is done in a "therapy pool" which is heated to bath water temp--very nice! Because the water supports your weight, there are things you can do in the water that you can't do on land. For example, I cannot yet do a full rotation on a stationary bike on land--I can only "rock" back and forth. But in the water, suspended with a flotation device, I was actually able to "bike" getting all the way around. Perhaps if you google it you will find something local? Good luck!

      Report / Delete Reply
    • Posted

      I hope you can find something! York is one of my favorite cities in the whole world--it is so beautiful. I lived in Harrogate for a number of years. Perhaps there is even something associated with the Baths there? Good luck!

      Report / Delete Reply
  • Posted

    WHAT IS AN MUA? 2nd time asking???

    Report / Delete Reply
    • Posted

      Manipulation Under Anesthesia. Surgeon who did the TKR performed the procedure. Essentially, they put you under (light sedation) so you don't feel it, then bend the knee, just as they do in physical therapy. But because you are not feeling the pain, they can bend it all the way and get through the scar tissue and adhesions. The surgeon said he bent it about 120 times! The procedure itself took about 10 minutes--they wheeled me into OR at 7:30 and I was waking up in recovery at 7:57, and home by 10:45. Now, coming home, I could not achieve the bend he did under the anesthesia--I will have to work up to it--but at least the scar tissue and adhesions are gone, and I know that I can get there.

      Report / Delete Reply
    • Posted

      Judi,

      Thanks so much for the explanation. How long after post op did your surgeon decide you needed it? How painful after you had it was it? It would be worth it to get rid of the scar tissue and adhesion's. I am a month post op as of today. I can sit and pick my leg up and out almost straight. I can bend it back under the chair too. BUT the pain, swelling, numbness, burning etc are bad. Everyone keeps telling me I am doing so well, but it just doesn't seem like it to me. Pain fro 6-8 every day no matter what PT, exercises, biking, etc I do. It may feel fair for 20 minutes and then ZAP its all back. I don't go shopping, do my crafts, cook, or want to leave the house. My strength is not returning. All this is NORMAL???

      Report / Delete Reply
    • Posted

      Surgeon started "threatening" me at 3 weeks post TKR; he seemed to feel that I would have more adhesions than most and might need it. At 8 weeks, he decided we should go ahead with it, and scheduled me in for the next week (so exactly 9 weeks). What I have read is that MUA is most effective at 6-12 weeks. However, another patient in my PT practice had his done a few weeks at 6 months (different surgeon), and he is very happy with the results.

      Like I said, woke up in recovery in severe pain but it passed quickly with the application of heavy painkillers and I was home within a few hours, managing with ice and Norco.

      It seems that I was more comfortable than you--I went back to work at 6 weeks and was doing relativey well, just not bending.

      Best of luck to you!

      Report / Delete Reply
    • Posted

      Judi,

      I wonder why he felt that way. Heavy painkillers? My Dr. gave me Norco 5 after my surgery. That's it. I ended up a week later in his office from the pain and they admitted me and gave me 10mg. Today i saw him and he cut me back to 5mg even tho I told him I was still having 6-8 pain levels every day. He says there is nothing he can give me as I am allergic to several other pain meds. Glad things went so well for you.

      Report / Delete Reply
    • Posted

      I think it had to do with my previous surgeries on that knee (meniscus tears) and the level of osteoarthritis I was demonstrating. They gave me IV dilaudid in the hospital after the MUA and that quickly brought me to a place where it could be managed with oral Norco.

      Report / Delete Reply
  • Posted

    It's awkward getting conflicting advice, but I dont' quite understand what is not good about water exercising...It was amazing and I cannot see why it would be less effective. I am sure your physio has a lot of experience ... maybe its not a matter of her undermining, but just giving a different view. There are a huge amount of views on rehab post knee surgery! It may be she aware of your disappointment and doesn't want you to put the bar too high at this point. It all takes a long time. I cannot remember exactly when as it's too long ago, but I think I was around 115ish around 4 months post op....and this was fine. Things slightly less target driven re numbers here in the UK I think compared to USA, however, the main thing is that you have what you need, to function in all the areas of life you need to function in, not that a box is ticked for a number. My range of motion continued to improve right up to a good nine months , just gentle and slow...it happened. You are likely to have some real mood troughs post knee surgery, and what people say probably gets any anxiety or fear going...Again, people having different views can fling you into feeling unsure and insecure.

    I cannot get my leg right up to my butt.... but do I ever need to? No. I enjoy yoga and can do everything I ever wanted to do and could not do before the knee surgery. It must be hard to on the one minute had someone show you 135 and the next see 95... but from what I have read on here in the past after MUA this apparently backward step seems common. The swelling is a natural reaction and I guess when the manipulation was done, it wasn't all swollen up. Now it is, and that is going to affect your bend I should think. I am not medically trained, so I am only speaking from my own experience, of course, but I think I would try and do all you can to reduce the swelling as this helps a lot. This is what my PT's both said to me, as well as the exercises of course. It's a funny balance between not doing too much and doing enough.

    I hope things improve for you and try not to be discouraged. I hope this helps in some way. Take a look at my profile and you will see I wrote all about my own knee journey... I found keeping an account going helpful. Many people find keeping a journal helps them to appreciate the progress they are making, and it's very easy to overlook this or forget all those little steps forward we make. It might be an idea to keep your own, but make sure you note down all the little positives, not just keeping a record of your range of motion!

    Report / Delete Reply
    • Posted

      Thank you for sharing your thoughts. Yes, I do keep a journal and I agree that it's helpful. I know there will be ups and downs and I knew that what I got on the table during the MUA would not be what I had when I got home ... It was just one of those days yesterday! My goals are to be able to go up and down stairs (impossible at the moment) and to ride a bike (ditto). Also to be able to get on the floor easily with my 1-year-old granddaughter! I actually got to 100 today--that was encouraging and I will take it in stride (I hope) if tomorrow I do not progress or even regress. Thanks for your encouragement!

      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up