Two days after MUA

[percy p]

Friday I had my MUA, reason I have scar tissue in my right knee after two opp's, the last one Oct 04,   I have been unable to bend my knee and had lots of pain when I tried,   the os told me thay would bend the leg and give me some injections in theater.  It's now two days later I have the same movement as before and I still have the tightness and pain when I try to bend the leg to far,what this treatment has done for me It's to earley to say,   I now have to go back to the physio for rehab 2-3 times a week.     
          I was told that the only way to be rid of this scar tissue is to break it down and keep moveing the joint but has this MUA broken it down? I will have to wait and see, anyone else had this form of treatment with results?.

[sparkle999]

I had a scope on Monday. My OS was going to do MUA during the scope, but he said that as soon as I was under anaesthetic I had full flexion.

However, now I am 5 days post op with very little flexion, only about 60 degress. I go to physio 2x per week.

Lets hope it's too early to say, or we're both stuffed!!

Good luck
xx

[kneesknees]

Hey,

I had arthroscopy the Thursday before last (5th May) and the surgeon manipulated my leg back to 140 degrees flexion!  The most I could get before was 80 and I'd been walkin with a straight leg for a year.

Straight after the operation I was MUCH more able to bend it and the physio measured 110 when I went back but I feel like I'm losing it now.  I really hurt my knee on Friday after getting out of the car and planting my foot at an angle and now I think my knee is stiffening up again.  What can I do other than keep on bending it?

Also, how long have all you people that have had arthroscopy's had your stitches in for?  I'm having mine out Wednesday which will be one day short of two weeks with them in and at the top of where the stitch is now, the skin has grown over it!?!  Is this normal and is it gonna make it hurt when they take them out?

Thanx and good luck to you sparkle and percy, I really hope you're able to keep gaining flexion! 

Katy

[hottubpam]

Percy P,

Use the search engine on this bulletin board and type in MUA - you will find a lot of posts some horror stories like mine and a few success stories.  Just remember in reading them that an MUA for a TKR is different then MUA for other trauma/surgeries.

I am not a fan of MUA's and I consider mine not only a complete failure, but also a procedure that actually aggravated my condition. 

I am now under the care of an OS that has lots of experience with arthrofibrosis and am almost fully recovered.  He says MUA's should never be done on someone with recurrent arthrofibrosis (scar tissue).

If your scar tissue is back, I'd suggest seeking an opionion from another OS.

Pam

[Heather M.]

Unfortunately, often the only way to take care of scar tissue is to physically remove it.  The MUA does not do that, which is my primary complaint.  I was talking with the PT about it today, and she said with about 90% of the population, it doesn't matter what you do to them if their knee is full of scar tissue--they will usually just get better.  But the small group that won't often reacts very, very negatively to traumatic procedures such as MUA and forced bending in PT.  These can create stress to the knee, further trauma, and most importantly, SWELLING.  This is the mother of future scar tissue.  My current surgeon also believes in these so-called special knees the scar tissue bands may well be ruptured by the MUA (but maybe not, and often at the cost of healthy tissue), but since nothig is removed, the scar tissue bits can actually glom back together--especially when aided by the additional swelling that the procedures can create.  The key is to keep the knee moving in a passive way, twice daily PT, GENTLE work that does not cause pain or swelling, lots of ice, and elevation.

Heather

[Janet]

I had a MUA with a scope. My OS was able to get my flexion to 135 in surgery. It took me three months to get to 115-120 with PT, and that is the most I have ever gotten (which is fine). It was hard and painful work, but much better than being stuck at 60! Just because he got it to bend during surgery doesn't mean it will be easy now.

Janet

[sparkle999]

yes, but here's my question.

Was it EASY for him to flex your leg in surgery, or was it stiff and he pushed it past the point it was comfortable at??

just a question from a worried kneegeek.
xx

[Janet]

Well, that's what a MUA is....pushing it past the point it wants to go. That's why you are under anesthesia, because it is too painful to be awake. The point of a MUA is to break up the scar tissue and get the knee bending again. PT (and mostly your own work at home) will keep the knee bending.

My opinion is, though, that if they just do the MUA and don't scope it to take out the bits they broke up, they are just floating in there and can cause problems again.

Janet

[sparkle999]

MY OS said that I had full flexion before he even went into the knee, just fell under gravity and touched the back of my thigh.

He then did the scope, debridement and cleared out the knee. Now I have only 70 degrees flexion(about the same as before the scope) and I don't really understand how this could happen.

Maybe it's just the after effects of the scope, but flexion just isn't there
xx

[kat131]

I had an MUA last July.  12 weeks post-op of an ACL,PCL,LCL reconstruction.  The result was immediate.  Prior to the MUA I was only getting to about 50 degree ROM.  The day after the MUA I was at 125.  My doc did have me on a motion machine for 3 days and then for 3 hours a day for 2 weeks after to keep the tissue from re-healing.  He did say that there was an incredible "pop" during the procedure.  It was definitely  the way to go as PT was not getting it anywhere.  My OS said that 12 weeks post op is the optimum time to have the MUA done.  Its long enough to know if PT will work and not so long that the scar tissue will be too built up to be manually torn (vs. removed).  Possibly it was too late to be effective if your last surgery was in October?

[snookman]

Kat,

Thanks for the encouraging post on MUA. I am being scheduled for a MUA and scope scar tissue removal. It is very unfortunate our injuries are so similar. I hope you the best in your continued improvement.

If you have any new information, please let me know.

I will update everyone soon.

I hope to be as lucky as you with my MUA results.

I had an MUA last July.  12 weeks post-op of an ACL,PCL,LCL reconstruction.  The result was immediate.  Prior to the MUA I was only getting to about 50 degree ROM.  The day after the MUA I was at 125.  My doc did have me on a motion machine for 3 days and then for 3 hours a day for 2 weeks after to keep the tissue from re-healing.  He did say that there was an incredible "pop" during the procedure.  It was definitely  the way to go as PT was not getting it anywhere.  My OS said that 12 weeks post op is the optimum time to have the MUA done.  Its long enough to know if PT will work and not so long that the scar tissue will be too built up to be manually torn (vs. removed).  Possibly it was too late to be effective if your last surgery was in October?

[Heather M.]

Snookman,

To be honest, the scar tissue removal is what's going to fix your knee in the long term, so it's good that you're having that.  You can find lots of information on this procedure in the soft tissue healing problems section.  It's usually called a Lysis of Adhesions or LOA, sometimes an anterior interval release.  The actual surgery is important, but what is critical is your rehab program afterward.  You'll read lots of posts on this topic in the soft tissue healing problems section as well.

Good luck with your LOA.  Make sure your doctor does that BEFORE he does the MUA.  That should really only be done to verify that all the scar tissue has been removed.

Heather

[rickm]

I had an MUA on June 8th.  I was scared to do it, based on most of the info I read on this site.  But I asked my surgeon a lot of questions, weighed the pros and cons (I had been stuck at 42 degrees flexion for weeks) and decided to go through with it. 

In the OR, the surgeon got 150 degrees flexion.  He never heard any loud pops or felt scar tissue breaking apart.  The sensation, he said, was of stretching the leg (muscles) out.  In the days after, I was sore as all get out and felt I might have made a mistake.  My flexion didn't seem any better.  But I went to PT 3 times a week, worked very hard and gained degrees in ROM every day.  As of August 1st, I had 122 degrees active, 127 passive.

On August 10th I'm getting my hardware removed and hope to keep making gains in flexion after that.

MUAs are not fun--even my OS describes them as barbaric.  But so far (keeping my fingers crossed) it's working for me.

--Rick