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Author Topic: MUA Completed/Same Problems Exist  (Read 7100 times)

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Offline annie5970

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MUA Completed/Same Problems Exist
« on: July 14, 2010, 08:03:12 PM »
Hello Everyone,

I had a MUA on Monday, and although my ability to bend my knee has improved, I am still experiencing extreme pain and swelling in the same areas? I have a hard band of something on the lateral side of my knee toward the top, that was not solved during MUA? My surgeon wants to do a full work-up on my knee in a couple of weeks, to see what is going on in there. He did hear and feel some pops and cracks during the procedure, but most of the problems still exist (pain, swelling, stiffness, hardened areas). Has anyone experienced this after MUA? I am just over 3 months post-op from the surgery that caused this yet again. I had surgery in November too, that resulted in a lot of scar tissue. The scar tissue was just everywhere when he went back in to debri my knee and do a lateral release in April. After the April surgery, I developed an enormous hematoma in the joint, and had to be taken back into surgery a week later to shave it out. Now I have scar tissue problems yet again. I am afraid the MUA has not done enough to correct the problem? I am totally bummed and severely frustrated.

Annie
Jan 09-Surgery for torn mensicus/synovitis
Nov 09-Scope-Extensive Synovitis/Plica Removal
Apr 10-LR-Scar Tissue Removal
Apr 10-Hematoma Evacuated
July 10-MUA
Oct 10-Scope/Synovitis/Extensive Scar Tissue/Chondromalacia/Maltracking
Nov 10-TTO/Scar Tissue Removal
Knee Aspirated 20 Times
July 11-LK TKR

Offline starpolisher

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Re: MUA Completed/Same Problems Exist
« Reply #1 on: July 15, 2010, 11:04:45 AM »
So sorry Annie.  I have had several MUA's while the surgeon was either replacing a spacer that was too large in one knee or doing a revision.  It seemed to help but it didn't last.....I know there is danger in MUA's for those with scar tissue (I have it).....can be too rough and cause more damage and more scar tissue (from what I have read here). 

Suspect doctors are seeing more AF cases with increased TKR's and if that is the case, hoping they will put more time and money into researching this very debiliating condition.

Offline Lottiefox

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Re: MUA Completed/Same Problems Exist
« Reply #2 on: July 15, 2010, 12:07:14 PM »
Hi annie

I was wondering if you'd had the MUA as i remembered your original post. I can't comment on any specifics but I really hope that things do improve for you soon. I can imagine how bummed out you are after what you've been through and yet more surgery in sight.

Sending you all best wishes and hugs

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline missmyknee

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Re: MUA Completed/Same Problems Exist
« Reply #3 on: July 15, 2010, 10:24:00 PM »
Hi Annie

I'm sorry you are still having problems. Usually for people with AF without a TKR, a gentle MUA can be done in the very early weeks after surgery. This is when the scar tissue is still wispy and soft and can easily break apart. After 10- 12weeks, arthroscopic surgery is done to remove scar tissue first, then a gentle MUA is done. You were on the far end of the scale with your MUA. Your doctor heard scar tissue pop but it is still in there. Also scar tissue can be attached where an MUA is not going to affect it.

Right now your knee is in a high state of inflammation from the trauma and needs to get out of that state. You need to be icing it as much as possible. I hope you have an ice machine. Keep it elevated and use crutches. Do patella mobes and deep tissue massage to patella tendon and quad tendon. Do these several times a day. Are you taking a prescription anti-inflammatory? If not you should be to help the inflammation. My OS uses Celebrex.

Hopefully once the inflammation goes down, you'll be able to evaluate things better. Don't let anyone do aggressive PT on you as it will just feed the inflammation. Right now you should be doing quad sets, calf and hamstring stretching, SLR, gentle passive ROM , along with the pat mobes and tissue massage.

Pam

4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline annie5970

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Re: MUA Completed/Same Problems Exist
« Reply #4 on: July 16, 2010, 02:27:51 PM »
Hi Pam,

Thanks to everyone for your responses. Everthing you noted Pam is exactly what my PT has been doing, and I am very diligent about my home exercises. The swelling did decrease after the MUA, and now is back with a force. Now, somehting is grating, catching,and crunching under my kneecap toward the top every time I straighten my knee (it is very, very painful).Yes, I take an anti-inflammatory (Mobic). I am afraid we waited too long to try the MUA, and now it has done little good to help the situation.  This is so depressing. I just want this knee fixed, so I can have a normal life again. I am only 40 years old, and normally very active (especially in the summer). I have found myself sitting everything out that Ienjoy doing because everything I try makes my knee more swollen and painful in a matter of minutes :(
Jan 09-Surgery for torn mensicus/synovitis
Nov 09-Scope-Extensive Synovitis/Plica Removal
Apr 10-LR-Scar Tissue Removal
Apr 10-Hematoma Evacuated
July 10-MUA
Oct 10-Scope/Synovitis/Extensive Scar Tissue/Chondromalacia/Maltracking
Nov 10-TTO/Scar Tissue Removal
Knee Aspirated 20 Times
July 11-LK TKR

Offline missmyknee

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Re: MUA Completed/Same Problems Exist
« Reply #5 on: July 16, 2010, 05:15:39 PM »
Hi Annie

Summer time is the hardest to sit out from activity, I totally agree.  :(   AF is a very sloooooow process to go thru. The crunching you feel my be do to scar tissue that broke but still in there. Do extra deep massage to the area to see if that will help. After my last surgery for AF , my PT did pat mobes and deep tissue massage, 3 times a week, for 25-30 min, for 6 mos. How's extension?

Remember, ice,ice,ice !!   ;D

Pam

4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline annie5970

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Re: MUA Completed/Same Problems Exist
« Reply #6 on: July 16, 2010, 06:59:30 PM »
Hi Pam,

Extension is good. I have been able to maintain extension since surgery. I always put a pillow under my foot, to force my knee to straighten after surgery. I did not want to end up with that funny slight bend in my knee post surgery. When my PT gently pulls on the scar area in at the bottom of the medial side, it pulls a line right under my kneecap, and out the other side to the scar where the drain was placed after the hematoma. After PT today, I still lost 12-15 degrees of flexion from what I could do on Monday and Tuesday (just after the MUA). I am so upset, I find myself crying a lot out of frustration. I just do not know what to do now that this did not seem to work. Everything is stiffening back up faster than I can keep it moving. I wonder if he waited a bit too long for this to be a success? I had the last surgery in April, and he waited three months to attempt the MUA, even though I have a history of scarring down. Any ideas, suggestions on what should be done next?

Regards,
Annie
Jan 09-Surgery for torn mensicus/synovitis
Nov 09-Scope-Extensive Synovitis/Plica Removal
Apr 10-LR-Scar Tissue Removal
Apr 10-Hematoma Evacuated
July 10-MUA
Oct 10-Scope/Synovitis/Extensive Scar Tissue/Chondromalacia/Maltracking
Nov 10-TTO/Scar Tissue Removal
Knee Aspirated 20 Times
July 11-LK TKR

Offline starpolisher

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Re: MUA Completed/Same Problems Exist
« Reply #7 on: July 17, 2010, 12:41:24 AM »
Annie, Pam is so right...icing helps enormously.  And I agree about summer being the hardest time to be disabled.  I also have to wear compression hose due to venous stasis in ankles.....so hot and miserable!   
Please look into this: The "Elite Seat" that Dr. Shelbourne, Indianapolis, IN  invented along with one of his patients who was an engineer.  My knees were terribly bent and pain was bad.  (You might very well be able to do this over the phone or email.....at least try).  My knees were bent 30 degrees (cause of much pain) and 2 months of exercises and especially elite seat got my knees to 7 and 9 degrees respectively and able to get around better.  Had setback due to strep infection in toe, but slowly regaining.  He wants to get me to 0 degrees but will accept 5 degrees.  I know Dr. Noyes has a  special machine for bending (he's in Cincinatti).  I wonder if we could get both and use at home and regain much  more motion?  In fact, will post this question.

Offline annie5970

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Re: MUA Completed/Same Problems Exist
« Reply #8 on: July 17, 2010, 03:29:36 PM »
Thanks for the post Starpolisher; I appreciate your input very much. I am just down since the MUA did not really seem to work. My knee loosened up for about two days, then tightened right back down again. I do my home exercises faithfully, and ice, ice, ice for swelling, but it just is not doing the trick. I have been dealing with this for some time now, and I want it fixed. I am very thin, and can see and feel hard bands in my knee. Went to dinner last night (sat with my leg down for an hour or so). When I got up, I not believe the how the swelling had increased (it was shocking).  I hope my surgeon has a plan of attack when I see him on Monday.
Jan 09-Surgery for torn mensicus/synovitis
Nov 09-Scope-Extensive Synovitis/Plica Removal
Apr 10-LR-Scar Tissue Removal
Apr 10-Hematoma Evacuated
July 10-MUA
Oct 10-Scope/Synovitis/Extensive Scar Tissue/Chondromalacia/Maltracking
Nov 10-TTO/Scar Tissue Removal
Knee Aspirated 20 Times
July 11-LK TKR

Offline Jill M

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Re: MUA Completed/Same Problems Exist
« Reply #9 on: July 18, 2010, 02:47:20 AM »
Annie,
Sorry to hear you have had so many issue with your knee. I can sympathize with what you are going through. 
Hang in there. Like the others have posted- ice, ice, ice with gentle PT are in order to keep the inflammation down.

Jill
8/07 Right subtotal meniscectomy
4/08 Chronic meniscus tear, grade 4 changes
10/08- R distal femoral osteotomy, lateral meniscal transplant, tibia microfracture, osteochondral allograft femur
12/08- AF noted, LOA
2/09- MUA
8/09- extensive LOA, patella baja
1/20/11- TKR

Offline Carolyn2010

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Re: MUA Completed/Same Problems Exist
« Reply #10 on: July 18, 2010, 06:13:18 PM »
Hi Annie,

I'm so sorry to read that your MUA, at this point, has been disappointing in terms of swelling,
stiffness, and pain. On the positive side, I think you mentioned that you're better able to bend
the knee.

Based on the research I've done, there are four stages in the pathophysiology of joint stiffness:
1. Bleeding
2. Edema
3. Granulation Tissue
4. Fibrosis
Since you mentioned a hematoma in an earlier surgery, did your os address this issue
in your mua? That is, using a cpm to minimize hemarthrosis and periarticular edema. Because
I had excessive bleeding when I had a TKR 15 mos. ago, I was very apprehensive about
the MUA and rejected having one 4 weeks out. Also, in terms of pain, I couldn't handle it.
The pain persists and have reached the point that I can't go on with the status quo.
I'm at Stage 4. In 4 days, I will first undergo a radiation followed by arthroscopic surgery
with debridement and closed manipulation. I chose to have an overnight stay. My os
hasn't ordered a cpm, but hope to have that overturned for the reasons of minimizing
hemarthrosis and periarticular edema.

Offline starpolisher

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Re: MUA Completed/Same Problems Exist
« Reply #11 on: July 20, 2010, 02:21:12 PM »
I often feel it would be easier if we had physical access to each other.....it's a very lonely type of thing because we are disabled.  I moved here from NY, leaving friends behind and know no one here.  My son is going to IU but he has health issues and I also came for better PT from Dr. Shelbourne's clinic and while it helps, I am still disabled.  I am on morphine and sweat like crazy so hate going out in the summer.  Pain meds make you so HOT!  I lost a lot of progress when I had my strep infection in toe and desperately tryiing to regain it.  I feel I will never be able to get around that well and I am down.  I do so much of the exercises at home....hours worth!  If I didn't I would be far worse off! So while I am better.....it means I can walk around the house on a limited basis and do some cleaning rather than being more disabled and unable to do anything.  We have very hilly land and I have yet to be able to walk around our property!  My husband is very down about all of this.  God I hate this disability......it robs me of the life I had.....it takes away so many things I loved to do.

Offline Carolyn2010

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Re: MUA Completed/Same Problems Exist
« Reply #12 on: July 20, 2010, 08:53:19 PM »
star polisher - you, and others on this forum, have provided me a wealth of information and
I want to thank you for all the time you've spent sharing articles, knowledge and experience.
I'm sorry that you and your family are going through difficult challenges. While your body has
undergone several repairs, your mind seems to work just fine. You're one smart woman!

I've been on these boards hours and hours trying to absorb as much as I can to
prepare for my procedures...radiation, debridement, and MUA  in two days. I have
RA., OA, and Fibro. along with the AF. I saw my rheumy this morning and will start
Enbrel Aug. 1st. She GAVE me 4 syringes which are now sitting in the fridge. Several
years ago I was on Humira, then Orencia, and most recently Simponi. I perceived
Humira as working the best but had to stop because of insurance.

Starpolish, I hope you will soon look at the glass as being half full rather than half empty.




Offline Roma

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Re: MUA Completed/Same Problems Exist
« Reply #13 on: July 21, 2010, 08:45:59 PM »
It is amazing how we all are so different and yet our stories are so much alike.  The struggles we have with AF are all so similar.  It has changed all of our lives and keeps us from doing so many of the things we love.  One of the hardest things for me is that I look very healthy, and actually young for my age, but yet the pain in my legs controls everything I do.  When I look in the mirror I can see the stress in my face from all the pain, but few people know how much I am actually going through.  The past few months  I have found myself dreading getting up in the morning.  I know it is another day that I will struggle with the pain and how I am going to manage my day so I can cope.  I used to love getting up in the morning and always hit the floor runniing.  Now some days it takes me almost 2 hours just to get breakfast, shower, and get to the place where I feel like a real person.  I always try to keep hope, but I must admit that on the other hand I feel hopeless some days, just not sure where to turn for more help or if I really should accept my life the way it is.  I guess I fear being turned away by another doctor or having more surgery and in 2 years being right back where I am.  I guess I don't sound very positive, but I really do try to keep my chin up.  Thank the Lord that every once in a while for some unknown reason we have a "better day" (not a good day mind you)  than the ones we had before and then that little glimmer of hope comes back in and sustains us for a few more days.  I am actually having one of those today.

Roma

Offline starpolisher

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Re: MUA Completed/Same Problems Exist
« Reply #14 on: July 24, 2010, 06:14:25 AM »
Roma, I can honestly say that Dr. Shelbourne's "Elite Seat" is kicking in again and I am having much more pain relief from using it.  It straightens my knees.  It took about 2 months the first time I used it to gain relief and actually be able to go out for periods of time and walk around the grocery store (and then come home and ice, therapy, rest) but I had a partial life.....better than none, which I suspect is what is happening to you.  I then developed a strep infection in my toe and couldn't wear shoes or my orthotics and lost so much ground!  For the past 5 weeks I've been spending 5 to 6 hours doing pt at home daily and the Elite Seat is part of it.  Finally, the past 5 days, I am getting pain relief again.  I have posted (the subject title being something like "great idea").  Shall I call you?  I think I still have your telephone number.  I will see my therapist this coming week and ask her if you could have an elite seat at home.  It's expensive....approx. $2,500....I was fortunate as my insurance paid for it because of good letters written by my doctors.  They knew the alternative was more surgery.  It's not easy.  It is time consuming and can be boring and I have cried a lot.....but it is so worth it now.  Once my legs are very straight (and the elite seat is wonderful for straightening your legs), we will add pt for bending.  I do some bending exercises.  I have scar tissue in both knees like you do.  It's worth a try....happy to talk to you about it!  God bless you.