Manual manipulation under anathesia

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This group has been so helpful to me.  However, I saw my surgeon on Thursday and he's not satisfied that my surgical leg will not lie flat.  He wants me to put me under and manipulate my leg and start PT all over again.  Evidently there is scar tissue that he wants to try to break up.  I'm just beginning to feel myself again...I'm 3 months out.  I need your suggestions as to whether I can get it back over a period of time with continuing my exercises and water aerobics or whether I should let him manipulate my leg.  Won't breaking up scar tissue just create more scar tissue?  I'm still stiff but able to function almost normally.  I confess I'm scared about the manipulation.  Any help knowledge or suggestions would be greatly appreciated. I need to make this decision by next week.

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  • Posted

    I came close to having the manipulation under anesthesia also at 3 months.  I worked aggressively both at home and with my PT and managed to avoid having.  The risks described to me is that it is more painful than the original surgery, and there is a chance that our leg could be broken during procedure.  One of my sisters said it took her 5-6 months to straighten her leg.  See if you can go one more month before you make that decision.  You really have to work on your leg at home.  Laying prone (on your stomach) with either a weight on your TKR ankle or use your other foot for pressure at least 5-10 times a day for 2 minutes will really help.  Good luck.
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  • Posted

    I had total knee replacement in April. I was stuck at 110 degeees for a month, and very stiff. I had a MUA on Aug 7. It was no where near the pain that I had after the surgery. I could walk the next day and now have a 115 degree bend. I'm happy I had it done. 

     

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  • Posted

    I was told that it is a lot easier to bend the knee than to straighten it.  Glad you had a good result.
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  • Posted

    Hi Judith.

    I had a MUA on 8/1. My surgeon allegedly got my bend to 140 ( I say alledegly because Im not so sure that is possible) . Afterwards I was in a lot of pain which turned into extreme soreness. PT was brutal. I had to go for a week straight and the therapist was very aggressive which she had to be to maintain the bend which she was only able to get to 100. Probably due to the swelling and pain I was experiencing.

    I am now going into my third week of post MUA PT and while my rom is definitely better I feel like I have gone backwards in terms of the pain and swelling.

    As my Dr described it- it is PT under anesthesia. It was like a 10 minute procedure. Nothing to worry about and it does give you better rom. And I can feel a difference in my knee/leg, not as stiff as before.

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  • Posted

    I am 10 months post TKR.  I still cannot bend my knee more than 110 on a good day.  Most of the time is 105. This is exercising every single day. I still have the rubber band feeling.  At 4 months the surgeon suggested to do a Manipulation under anesthesia or go for another 30 days of PT. I chose the PT. You don't know how I wish that I had the manipulation done. I wish I could turn back the clock and have the manipulation. Many patients in this forum had the manipulation and are doing fine. However, I did not belong to the forum when the manipulation was offer to me.  Yes, you need to go to PT, but according to doctors and the people that had it done is not so bad and is not that painful. Please make a wise decision. My surgeon told that most likely I will have the pain the rest of my life.  Please let us know. Good luck. 

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  • Posted

    Saw my surgeon last Wednesday. I can not straighten my leg, it's bent at at 30 degree angle. I can bend my leg to 115 degrees. He prescribed a JAS brace which gradually straightens the leg by millimeters which is under my control. The JAS representative said it takes 3-9 months to straighten the leg using it for 30 minutes three times a day. I can feel it is gradually stretching the tight muscles of the calf, hamstrings and loosening the tightness/scar tissue behind my knee. The surgeon also said manipulation under anesthesia is for those that can not bend their knee. For those who can not straighten their leg, if PT or the JAS brace doesn't work, the alternative is surgery to remove scar tissue and that requires almost starting over again in rehab and PT. I am doing Epsom salt baths and taking magnesium which helps muscles relax. I am rubbing castor oil around and behind my knee. I see a massage therapist once a week to have her use massage to break up scar tissue. I am 3 and 1/2 months out from surgery and just now strong enough to get into my car, partially weight bear (left leg is about 4" shorter because of the bent leg) and walk with a walker. I am working diligently to straighten it with continued exercises to avoid surgery. As long as it continues to straighten, I don't care if it's 1/4 " per month, I will keep doing this instead of surgery and starting over in pain. Good luck to you!

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    • Posted

      It sounds like you are doing a grand job of looking after yourself and have a lot of determination! You are doing so well and it is great you are being very well supported and with plenty of resources to help you! Are you also stretching with exercises? Walking in water is also good. All best wishes to you...😊

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  • Posted

    Good luck on your decision Judith. This is such an individual topic with many doing well both with and without the MUA. I was at 13 weeks stuck with a 102 bend. I opted for the manipulation n have maintained -and added to my bend, currently now at 124. Yes I did have swelling and stiffness several weeks post MUA, and slight pain in my inner thigh (relieved with Advil and ice). PT daily for 10 days too. I have been on a CPM machine 6 hrs daily that is also helping. MUA was Not the pain I experienced post op total knee though. I m glad I did it, and now at 17 weeks, am finally feeling more recovered. This whole total knee replacement surgery requires daily hard work and has been the most brutal overall experience of my life. I really never expected the pain, emotional toll, or all the daily work required to get through post op rehab. You can do it! Hang in there. Many on this blog have amazing stories and information to assist you in your recovery.
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    • Posted

      Yes Carol this blog has been a life saver for me!  Because of people like yourself and others who have shared, I have found answers and support.  This TKR has been the most brutal physical experience of my life too.  I'm still undecided about this decision of MUA, but my gut is leaning toward not having it.  It's a terrible feeling of making the wrong decision.  I think I'll get a second opinion from another surgeon.  Thank you so much for the encouragement and sharing your own experience.

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  • Posted

    Hi Judith,

    ?The major weakness with this type of surgery is that nobody explains to you anything about 'SCAR TISSUE'.

    ?I was an already established client of a Sports Injury Massage Therapist and she advised me to return post op and she'd work on the scar tissue. So, once the dressing was removed and it was confirmed there was no infection, ( about 14 days post op) she went to work twice a week massaging the incision line and surrounding area. This went on for some 6 weeks until I got the bend and the leg 'straightness' desired.

    ?I'd qualify this by saying also once the stitches/staples had been removed. In my case I was fortunate in that my 'stitches' were self disolving staples which made it easier for the therapist to get to work. 

    Of course in addition to this I did my PT myself at home - 5 times a day, every day and the ones I concentrated on were heel slides and leg straighteners.

    ?Personally, and I'm biased, I'd be going for intensive PT massaging the incision line first as I did.

    Good luck.

    John

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