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Author Topic: need advice on MUA  (Read 10750 times)

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mavrick

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need advice on MUA
« on: January 02, 2005, 12:11:35 AM »
Hi,
I had a TKR on December 17th, I am 49 yrs old.  This was my first and LAST TKR as far as I am concerned !
The pain has been unbearable and at 2 weeks post-op I only have a ROM of 50 degrees.....they want me at 90 degrees by now. They are talking of doing the manipulation. Can some of you please tell me what to expect after this procedure?  Is there more pain afterwards than the surgery itself?  When you wake up from anesthesia is your leg in the CPM machine right away?  Are you in terrific pain from the procedure since they bent the knee beyond what you could do on your own?  Do you lose the ROM you had before going in for MUA?  I do not want to lose the 50 degrees of ROM I already have, do you have to start from scratch again?

Has this helped some of you with better ROM when you resumed therapy? I am scared to death having the MUA done, so please give me all the info possible. Thanks so much !  Finding this website was a godsend !
You may also privately e-mail if you wish, with your explainations.   E-mail: [email protected]

Steph

Offline AndrewC

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Re: need advice on MUA
« Reply #1 on: January 03, 2005, 07:29:48 PM »
Hi there Steph

Sorry to hear about your current bad time with the TKR  :o although 2 weeks post op TKR is extremely early and I don't think I had much more ROM than 50-60 degrees 2 weeks after my Meniscus Repair  ;) In fact it was 2 1/2 months before I could do a tender rotation on a stationary bike!! (although my leg had been locked in one position for 4 weeks prior)

Anyway....back to the MUA.
In general (and I don't want to make you more apprehensive) MUA's are....by their very NATURE....quite brutal  :o

TKRs are notorious for creating Scar Tissue within the joint due to the trauma of the operation / the prosthesis itself...and the damage to the soft tissues/or joint that was already present to make the TKR necessary (in many cases anyway)

Aside from swelling, the formation of scar tissue could well be what is hindering your ROM (although 2 weeks is VERY early....there may be some adhesions that have formed in this period)
The MUA is intended to break up the adhesions and free up some movement in the joint by the use of force......:0

The procedure can and does sometimes result in the breaking of OTHER structures in the knee such as ligaments, patella tendon....even the tearing of quadraceps muscles has happened to someone on this site :o BUT.....
this is usually from MUA that are further down the line when scar tissue has really got a grip. At two weeks post op the bands may well not have formed properly which would make the MUA less risky (depending on how much you trust your OS?!)

For these reasons it is often NOT performed on it's own by many good and respected surgeons. Instead, a procedure called a LOA (lysis of adhesions) is performed under arthroscopy where the bands of scar tissue are trimmed and removed surgically as much as possible......then...a GENTLE manipulation is performed to ensure that a satisfactory ROM has been gained by the procedure.

You are very WISE to be concerned about an MUA and you should find out if it is to be performed in conjunction with a LOA....if it isn't....get a 2nd opinion!

The reason why a LOA is often vital after a surgery like a TKR as opposed to a straight manipulation is that when the scar tissue is broken up during the MUA (if indeed it is as scar tissue is sometimes stronger than other tissues in the leg thereby resulting in extra damage) it does not have anywhere to go except the area it has come from! This can mean that it congeals over time and rears it's ugly head back up soon after...when it has reformed...globbed back together and binded back to the joint again.

Meaning that the ROM people often gain from MUA can deteriorate over the next weeks or months back to where they were before...or worse

Also...the trauma to the joint of a MUA can itself cause the production of more scar tissue thereby creating a vicous circle....

Have a read of the link below which details a few similiar problems with TKR patients and some useful info

http://www.kneeguru.co.uk/kneegeeks/3891625901.html

Also, you would be very wise to read the "soft tissue" section of this site as there is some VERY good info pertaining to TKRs and scar tissue problems. Called arthofibrosis...many surgeons do not have much experience of dealing with the condition of excess scar tissue, and a specialised rehab is often called for. This part of the site will outline other peoples experiences and how there problems were dealt with

http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl?board=softtissue

Hope this helps

All the best

Andrew C

« Last Edit: January 03, 2005, 07:33:34 PM by andrewc »
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline kath

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Re: need advice on MUA
« Reply #2 on: January 04, 2005, 01:57:03 AM »
Hi Steph...like Andrew, I am taken by surprise that they would be discussing MUA at such an early stage as 2 weeks post-op.  Do you even have your staples out yet?

I had partial replacements in both knees in early November at age 49.  My ROM at two weeks may have been close to 90 degrees, but PKRs are easier than TKRs.

I'm wondering if this information has come from your OS or your physiotherapist?  I would ask more questions.

Also, you may wish to read up on the TKR section of this bulletin board...perhaps someone who has had a TKR can let you know their experience.

Good Luck!  Kath
Bi-lateral unicompartmental Nov 2004

Offline Jan_L.

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Re: need advice on MUA
« Reply #3 on: January 04, 2005, 02:23:57 AM »
Hi Steph,

We have the same history.  I had a TKR 12-4-03 followed by two MUA.  

First of all a TKR is very different from other surgeries.  Most people can bend their knee 90 degrees before they leave the hospital.  After a knee replacement it's critical to get the knee bending.  With your limited ROM you are in trouble!! I wish my doctor would have done a MUA sooner, he waited a 5-6 weeks and my leg still doesn't work, I am scheduled for a full revision in March.  I think most OS prefer to do a closed MUA because of the risk of infection that comes with having an implant in your leg.  Having a TKR changes everything, it really does.  So a lot of the standard treatments don't apply when you have had TKR.

If you can't bend your knee at least 90 degress then it is considered a fail knee replacement.  You need to be able to bend 90 degrees for the leg to be functional.  You doctor is right to be VERY concerned about you lack of ROM.  You need to get your knee bending to 90 degrees as soon as possible!

Both of my MUA didn't fix my knee.  At the soft tissue section there are a couple of other people that have had TKR and are struggling with scar tissue, see what they suggest.  

In my opinion two weeks is NOT to soon to do a MUA. Although I don't know how helpful it will be.   Check with other people that have had a TRK, see what they say.  Keep in mind that once people get well they are no longer spending their days leaving messages at a knee web site.  I don't think the MUA worked for any of us here.  But the longer you wait, the scar tissue that's preventing your leg from bending gets stronger.

Arthrofibrosis  (scar tissue) tends to be quite painful, is your pain being managed?  How often do you have PT?

I am still searching for answers.    Good luck.  Feel free to contact me if you have any questions.  Check the TKR and soft tissue section for more info.  

Jan
« Last Edit: January 04, 2005, 03:58:52 AM by Jan_L. »
1985 - auto accident- both knee went thur the dash.
1985 - 1990 Four scopes left knee
2002 - Fulkerson TTT
2003 - Scope Rt knee
2003 - Right  TKR
2003 - MUA, 2004 - MUA
2005 - Right TKR  revision
2006 TKR - left knee, 2 MUA
2007 2nd TKR  revision - Rt knee

mavrick

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Re: need advice on MUA
« Reply #4 on: January 06, 2005, 10:28:05 AM »
I was doing my exercises at home and did not have PT for 5 days dues to the weekend and an ice storm one day and 12" of snow the next day.  However I sat at home and kept pressure on my knee in a sitting position for about an hour and half at a time, while seated in a chair at the computer. I kept creeping my foot back as far as I could, while in the chair.  I was stretching out the muscle I thought.  I was having alot of pain on the inside of the knee when attempting to bend.  However now that inside of knee pain is gone, and now I have less ROM as it feels as if there is something stuck under the kneecap and I can bend it less than before.  Any ideas what that is all about?  
I have PT 4 times per week. I have been doing 100 knee tightening exercises per day, as PT instructed to build my muscle.  I cannot lift my heel off of the table as of yet either.  The knee tightening exercise is to build up the thigh muscle and thigh muscle from my understanding.

I will be 3 weeks post op this Friday with TKR.
I am still taking Vicodin for pain meds.
Thanks for your replies.

Offline Jan_L.

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Re: need advice on MUA
« Reply #5 on: January 06, 2005, 04:35:27 PM »
HI Marvick,

I am glad to hear that "while seated in a chair at the computer, I kept creeping my foot back as far as I could."  This is a good way to work on ROM.  I don't know if any one has told you but following a TKR it is so important to get your full ROM as early as possible.  On a scale of 1 to 10, it's a 10!  The longer you go without being able to fully straighten or bend your leg the chances increase that you will NEVER be able to fully bend or straighten your leg.  This is why your doctor is already wanting to do a MUA.  

Exactly what is your ROM now?  If you are still anywhere near 50 degrees you are in trouble!!!  If you haven't made significant gains by the end of this week the I would have the MUA or a LOA (lysis of adhesions)  right away.  Most of the people here would tell you that a MUA didn't help them, but if it had, they wouldn't still be here.  I would ask your OS about the sucess rate of a MUA, it doesn't look very sucessful based on the reports here.   The longer you wait the stronger the scar tissue becomes and the risks increase  of something  (bone, implant, tendon...) other  than the scar tissue breaking free when the doctor forces your leg to bend while under anesthesia.  Someone here posted that his bone shattered during a MUA, I think his doctor waited to long to do it, but I really don't remember the details.  There's just a short window of opportunity is which MUA is an option.

Is the vicodin handling your pain?  It's important to have your pain managed so that you can do the PT.  It's not uncommon to need pain meds for up to 3 months following a TKR.

I am really not sure what's going on with the inside of your kneecap.  My guess would be it's scar tissue but I honestly have no idea.  If this feel quite different then I think you should have you OS check it out.

I hope some of this helps.  Follow the post under the TKR section.  I will let you know how I deal with my knee.  I have limited ROM and my knee is very painful so I am gattering info and trying to decide how to proceed, full revision or a LOA (lysis of adhesions).   I hope you can get that knee bending so that you don't follow in my footsteps.  

Jan
« Last Edit: January 06, 2005, 04:52:29 PM by Jan_L. »
1985 - auto accident- both knee went thur the dash.
1985 - 1990 Four scopes left knee
2002 - Fulkerson TTT
2003 - Scope Rt knee
2003 - Right  TKR
2003 - MUA, 2004 - MUA
2005 - Right TKR  revision
2006 TKR - left knee, 2 MUA
2007 2nd TKR  revision - Rt knee

Helen_uk

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Re: need advice on MUA
« Reply #6 on: January 06, 2005, 05:34:38 PM »
I had an mua after one of my ops and to be honest I had had so much pain before that when i woke up it felt instantly better  they started me on the cpm the next day and I never looked back I was 5 weeks post op and it was a good experience for me
Love H xx

mavrick

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Re: need advice on MUA
« Reply #7 on: January 06, 2005, 05:39:23 PM »
Oh thanks for a GOOD word that it did work for someone. That makes me feel better, as I was reading all of these horror stories and getting more scared as I read.   Did you have much pain after the MUA?  How much ROM did you gain after the MUA?  I am also hoping if they do this, that it will work for me and I can continue with further ROM gaining.  Thanks for your reply !
Did your therapy go much smoother and pain free or almost pain free after the MUA?

Offline Leentje

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Re: need advice on MUA
« Reply #8 on: January 07, 2005, 02:14:10 PM »
Quote
Hi there Steph

Sorry to hear about your current bad time with the TKR  :o although 2 weeks post op TKR is extremely early and I don't think I had much more ROM than 50-60 degrees 2 weeks after my Meniscus Repair  ;) In fact it was 2 1/2 months before I could do a tender rotation on a stationary bike!! (although my leg had been locked in one position for 4 weeks prior)



A TKR can't be compared with any other knee surgery!!!!! It is true that you should be able to bend at least 90 degrees within 2 weeks or you are in big trouble. the fact you didn't have PT for 5 days will be most likely the cause you don't have good ROM now. Post TKR PT is crucial, you must take painkillers so you can give yourself 100% in PT.

What can be is that you can't bend due to tensed muscles. your OS will be able to tell you this post MUA. In our hospital 80% of the peoples knees bend directly 135 degrees once they are under anesthesia (muscles are relaxed!!!) and most of the MUAs are done because patients lack of PT (they don't think it's necessary and we PTs and nurses are like devils who llike to see patients in pain  :o we are not we just knnow how important it is but have to say also in out area a lot of people are have social and financial problems and want to take everything on insurance :( :o :o :o :o :o).

MUA wise : You'll might te expect to be in a CPM post MUA. I hope they give you good painmanagement (both post-MUA wise plus you MUST bend!!! as I told before!) and please work your butt of to get ROM as good as can be!!!!!!!!!!!!!!!! Take painmeds and get the ROM over 90 degrees ASAP. Or you'll stay in big trouble. Also you won't get ROM over 90 degrees on your own or with just PT when you're over 3 weeks post-op, you'll need some help :-/

Hope this helps!!!

Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline Jan_L.

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Re: need advice on MUA
« Reply #9 on: January 10, 2005, 01:51:52 AM »
Hello Maverick,

I have some good news for you.  I was talking with Janet this afternoon and she told me that a while back someone had posted that they had had a TKR and had to have a MUA because of limited ROM.  The MUA took care of her problem 100%!!  She didn't have any complications and was able to regain ful range of motion.  Which is what I had suspected, those that get well, move on with life.  Only those of us that have had poor outcomes need to continue to look for help, those that are well, are out in the world enjoying their good health.  

So there is no reason to believe that you won't also have a good outcome!  I have been reading a lot of articles in medical journals this weekend and it was suggested that a MUA had to be done before 3 months post-op.  They also stated that it should ONLY be done if you HAVEN'T been able  to made any progress in PT.  So, I hope you are doing better now and if not then a MUA could correct your problem.  If you do decdie to have a MUA then I have some suggestions for you.  I wish you the best.

Jan
1985 - auto accident- both knee went thur the dash.
1985 - 1990 Four scopes left knee
2002 - Fulkerson TTT
2003 - Scope Rt knee
2003 - Right  TKR
2003 - MUA, 2004 - MUA
2005 - Right TKR  revision
2006 TKR - left knee, 2 MUA
2007 2nd TKR  revision - Rt knee

mavrick

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Re: need advice on MUA
« Reply #10 on: January 10, 2005, 06:13:22 AM »
Jan,
Please send the suggestions you have about the MUA.
It sounds as though I have no choice now......am back to 55% of ROM as of last Friday again.  We have lost 2% over a few days. I see my ortho doc this Wednesday. PT said they will fax my progress report to him before my appt, so he knows what is going on.

However I was able to do my leg lifts now, we finally got the quad muscle to fire last week...so we are making progress in that area.

Will I lose what ROM I have now after the MUA?  And no one has really anwsered my question....how painful or sore are you after the MUA is done?  If so, how long is the high pain level after MUA before it subsides?  Right now my pain level is not bad, I can stand on the leg with most of weight now (I weigh 150 lbs.)  It just gets really stiff and somewhat sore yet if I go past my 6-8 hours without the Vicodin pain meds.

Also it feels like there is a huge thick rubber band around the front and just below my knee cap. I assume this is the scar tissue building up there?   I was having lots of pain on the inside of the knee, but that has also subsided some since doing agressive PT at home and in PT office. I am doing 100 leg lifts and 100 kneecap tightening exercises per day.  Plus stretching/bending the knee to the best of my ability.
Thanks so much to everyone for this forum, it gives me hope !

Steph

Offline Heather M.

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Re: need advice on MUA
« Reply #11 on: January 10, 2005, 11:53:16 AM »
Steph,

You always have a choice.  I probably shouldn't write my opinion of MUA's here, because I'm tired and a bit cranky and I just know I won't be diplomatic.  But suffice it to say that I've had one done and while it did little benefit in the long run, I actually was one of the lucky ones...at least I didn't have anything else in my knee tear or rupture during the manipulation! There are quite a few horror stories on here of patella fractures (broken kneecap), tendon ruptures, ligament problems, and even a broken FEMUR from an MUA done post-TKR.  I have no idea why this procedure is still being done, as it's pretty brutal. My current surgeon is a specialist in dealing with scar tissue (and this would be the only reason to have an MUA recommended) and he does not do these procedures.  Instead, he goes in with a scope and cuts away, then physically removes the scar tissue. His belief is that if you don't remove the bands of tissue, then they can just glom back together again and you will have a patient with initial good results, then a slow and steady slide downhill after that.  This fit me to a T.  I had only 85 degrees of flexion and was missing several degrees of extension when I went in for my MUA (this was done by my FORMER surgeon).  

To reassure you, the MUA only took about 10 minutes from pre-op IV insertion to post-op recovery.  I came out with 135 degrees of flexion, but was still missing plenty of extension.  Actually, my extension deficit got worse, because the MUA can't do anything to help you straighten your leg, and in my case it caused a TON of irritation, pain and swelling.  This got in the way of me being able to straighten my leg fully.  

So anyway, these are my major issues with the MUA:  1) It doesn't remove the scar tissue from the joint.  2)  It can cause extreme trauma and start the body producing scar tissue all over again (swelling/inflammation are the mother of scar tissue according to my current OS).  3) It does nothing to address scar tissue in other parts of the knee, especially the stuff that causes reduced extension or keeps you from fully straightening your leg.  All the MUA does is (sometimes) break the bands of scar tissue that are blocking your ability to bend.  4) MUA can only be done early in the post-op process--otherwise, the adhesions can be so thick that they are stronger than the other structures in the knee...so the force required to break the scar tissue is greater than the force tendons and ligaments and muscles can withstand.  This can lead to complications like broken bones and ruptured muscles/tendons. Most of these you can recover from, but I sure would want to avoid them if possible.  

I find it so interesting--and telling--that when we read the post-op protocols of people who see scar tissue specialists (doctors who work with lots of arthrofibrosis cases, and who have developed their own procedures and treatment techniques for arthrofibrosis post-op care), there is no mention of anyone having an MUA.  It seems to be something that TKR doctors and most generalist orthopedic surgeons perform.  

Now, I have to say:  I haven't had a TKR.  And I'm almost positive that my OS doesn't do TKR's--his partner takes those cases, I believe.  But I've been researching scar tissue treatments for years and trying to absorb and document as much info as I can.  So I do know that a TKR is different from all other kinds of surgeries, and dealing with a prosthetic knee is going to change botht he decision-making process and possible treatment plans.  

But I can't help it--when I think about what's done during an MUA, it just makes me cringe.  I know my opinions and advice are flavored by that reality--so I try to be up-front about it.

Cont'd
« Last Edit: January 11, 2005, 09:22:16 AM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: need advice on MUA
« Reply #12 on: January 10, 2005, 12:03:31 PM »
Despite my feelings about the procedure, I'll tell you what my old doctor told me would happen during my MUA:  the anesthesiologist would put me to sleep, and the OS would pick up my bad leg in both hands.  He'd put one hand behind my thigh near the knee, then lift my lower leg with a hand around my ankle.  With the leg supported in the air, he said he'd remove his hand from my lower leg, keep the other hand at the back of my thigh, and then 'let gravity do all the work.'  See, I was less than 5 weeks post-op, so my OS didn't really believe I could have tough, fibrous, strong bands of scar tissue in there.  He thought my problems were muscular or something--wrong!  He got my leg to 85 degrees of flexion, then it just stopped.  And he fiddled and fooled and tried to coax it to bend more, but nothing happened.  My flexion had a 'solid end point.'  So the OS got up on a stool near the operating table so he could apply more force.  He took my ankle/heel in his other hand and started to force the knee to bend using his strength.  He said he heard three very loud pops as the adhesions ruptured, and was able to get my knee to 135 degrees of flexion.  Then he injected some cortisone and I was sent to post-op.  I rested there for about 30 minutes while they worked on getting my pain under control.  The worst pain was right at the top of the knee, or all across the bottom of the quads.  The second worst area was down the lateral (outer) side of the knee, where he'd heard adhesions popping.  But it wasn't as painful as waking up from surgery by any stretch.

After being pumped full of drugs, I was sent straight to PT.  I was pretty much high as a kite and am told I was quite talkative and entertaining.  ;D  I was not feeling any pain, but my PT kept things light.  I had crutches, but hadn't been told anything about using them, so I just kept them for comfort more than anything else.  A few days later, I had severe muscle spasms, which is apparently a common problem following MUA.  They were excructiating, but could be controlled by using crutches, easing up on the PT, and taking muscle relaxants.  Anyway, I recovered from the muscle spasms (which I'd had after each surgery in a minor way) just fine, and was more careful after that to use my crutches.  I had them for about a week or so.  Unfortunately, while I was able to keep most of the flexion I'd gained (I went between 120-125 flexion following the MUA), I still had scar tissue in other parts of the knee.  And I was still missing a good bit of extension, which the MUA can't do anything about.  So about 2 months after my MUA I had to go in for a surgery to physically remove the scar tissue and try to get my extension back.  The MUA didn't really help me in the long run, in other words, although I can't say that it hurt me in the long run, either.  The spasms weren't pleasant, but I know now that there are much worse complications that you can have from the procedure.

(Cont'd)
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: need advice on MUA
« Reply #13 on: January 10, 2005, 12:04:04 PM »
(Cont'd == too tired to edit to fit in two posts  ::)  )

A lot of surgeons out there believe that an MUA after a TKR is logical, because the body is producing lots of scar tissue in response to all this foreign material in the joint.  Some scar tissue is absolutely normal--it's how our bodies heal.  But too much can create significant problems, and the methods used to get rid of it should take into account that scar tissue is the response of a terribly traumatized knee.  That's why my current OS doesn't do MUAs--he feels that it's heaping trauma on top of more trauma, and that it can even set off the whole inflammatory/scar tissue producing phase all over again.  Which is exactly the last thing you want in my crazy knee...it forms scar tissue out of control all by itself, thank you.

You should definitely look through the soft tissue healing problems section, as well as this crisis board.  You'll find lots of posts on MUA's and other techniques for dealing with scar tissue.  The way my current surgeon takes care of scar tissue early in the post-op process is to fill the knee capsule full of saline solution under pressure.  This is actually what's done during an arthroscopy, only during this other procedure no instruments are introduced.  Instead, as much water as the knee capsule can hold is pumped into the joint, and the left there for 5-10 minutes or so.  Then it is extracted with a large gauge needle (you are asleep, so there is no pain) that can actually draw out the fluffy bits of scar tissue.  This procedure is called an insufflation, and like I said it is part of the normal arthroscopy process.

The MUA didn't help me much in the long-run, and I ended up having another surgery to remove the scar tissue anyway.  I was able to keep some of my ROM from the MUA, but it was slowly going away as time went by, and I still had lots of pain from scar tissue in other parts of the knee that were not affected by the MUA. Still, a TKR seems to be the rule-breaker, and lots of people have MUA's each year following knee replacement surgery.  So hopefully you'll be one of the lucky ones who doesn't have any complications.  Perhaps that is why your OS is pushing for this MUA so soon, to do it before your scar tissue matures and hardens...but if you are improving each day or week in physical therapy, then it might be worth persevering.  Your doctor can't do any procedure you don't consent to!!  If you tell him you want to continue to work in PT and doing little mini sessions at home, he should be okay with that, as long as you can show progress.  While I understand it's critical to reach that 90 degrees of flexion milestone as soon as possible, it's also true that some people just heal more slowly than others.  No mystery, just genetics or being in great shape, or whatever.

You might want to read through the crisis section, struggling with rehab/pain section, and the soft tissue healing problems group of threads.  You will find all sorts of info on ROM problems, MUA's, missing extension, and things that can be done at home to improve ROM.  There was a thread called "Bend it til I scream" in the soft tissue problems section that gave good information on what the patients can do in order to work on ROM.

Hope some of this information helps.  I can honestly say that I wasn't hurt by the procedure, nor was I particularly helped.  I did get a short term boost in ROM, but it went back down again.

Heather

PS Helena's advice on what you will have after is great--CPM is critical, for as many hours a day as you can stand (I did 18-20 after my last surgery).  And be sure your pain is adequately managed so you can move.  For me, I found it better to bend my knee to the point that it just started to hurt, then back off a little and hold the stretch for 1-2 minutes.  This worked better than bending to I was ready to pass out....
« Last Edit: January 10, 2005, 12:06:52 PM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline Sandy_F

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Re: need advice on MUA
« Reply #14 on: January 10, 2005, 03:38:38 PM »
I had a TKR and 3 1/2 months later I had a MAU.  It was the best decision I made.  I was losing ROM and pain was increasing.  I was still needing a cane to walk.  I must admit the pain when I woke up was quite bad.  Even with a femoral block, I hurt.  By the next morning I was sore but not really in pain.  I was using crutches and within a week I was walking unaided.  I had PT every day for a week.  I did get ROM back, not as much as I expected to, and had great relief from the pain.  

A MAU is not something I enjoyed but I did make the right decision in having it done.
Right knee - 14 surgeries including a fulkerson, patellectomy and finally a TKR.  Left knee - Lateral release, microfracture, TKR, then another LR, spacer replacement.















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