Advertisement - Hide this advert





Author Topic: Possible MUA or scope  (Read 2250 times)

0 Members and 1 Guest are viewing this topic.

Offline loverlylg14

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Possible MUA or scope
« on: November 11, 2014, 05:58:10 AM »
Hi All,

In February I had a synovectomy on my left knee, I know that usual recovery is like nothing and people are back on their feet within 2 weeks. However, I was on crutches for a month and could not bend my knee or straighten it immediately after surgery and for the next 10 months. I kept thinking it would get better but I still can bend it without intense pain and cannot run. The doctor gave me the choice of MUA or a scope to break up possible scar tissue. I was just wondering since I am a school teacher, how long the recovery for MUA is and what ya'll think. They thought I had nerve damage and gave me neurontin and mobic and it did nothing, they also drained a lot of fluid from my knee with no improvement as well as giving me cortisone shots. after 1 month of Pt I was told my ROM had gotten worse and they didn't think they could help. I'm at a loss of what to do!!! Ideas??? My recent MRI also says that I have a sprained ACL and scarring on my Hoffa's pad, both of which should not cause as much pain as i'm experiencing.

Thank You!  Lauren

Offline Scubagrl4

  • Forum Faithful
  • ****
  • Posts: 274
  • Liked: 43
Re: Possible MUA or scope
« Reply #1 on: November 12, 2014, 03:27:09 AM »
After 10 months, I don't think an MUA is a good idea. Even though the thought of more surgery sucks, you also don't want to waste any more time being hurt. I had an MUA after 3 months and ended up with damaged cartilage and a lateral meniscus tear. I also lost a few degrees of extension. I had no pain relief until the scar tissue in my knee was actually removed along with proper rehab for arthrofibrosis. I just think after 10 months you would be taking a big risk with only a small chance for improvement.
Just my own personal opinion. I wish I hadn't wasted my time with a MUA.
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Bullet Tooth

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
Re: Possible MUA or scope
« Reply #2 on: November 15, 2014, 12:09:15 PM »
I've had both. MUA (4wks ago) on my knee and capsular release (2 yrs ago) on my shoulder. Clearly mileage may vary but for me, MUA was REALLY painful and I'd take a release in a heartbeat!

I think the MUA is just less controlled. It's tearing things through brute force. Mine flared up an old calf injury and I'm struggling more with that than the knee at the moment. I think arthroscopy is more precise. Just my experience, I'm no Doc.
B

Offline loverlylg14

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Possible MUA or scope
« Reply #3 on: November 25, 2014, 02:28:36 AM »
Thank you both! I am continuing to mull it over and I keep coming to the same conclusion as you both stated. I just hate being in pain and not being able to do anything athletic. it sucks. :-[

Offline Scubagrl4

  • Forum Faithful
  • ****
  • Posts: 274
  • Liked: 43
Re: Possible MUA or scope
« Reply #4 on: November 26, 2014, 03:17:13 AM »
Believe me, I feel the same way. But, with either choice, you will still be out of sports for quite some time. I do think am MUA is an acceptable option (kind of)... I just had another with insufflation, and am currently regretting it, and that is only after about 7 weeks post op. The pain was significantly less with the scope. And once again, that is only after 7 weeks. I can't imagine how it would feel after 10 months, and I can't imagine how it would help after 10 months. That scar tissue has got to be pretty strong at this point.
Keep us posted on what you decide....oh, and be sure to find yourself a good doc with strong knowledge in dealing with scar tissue.
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline loverlylg14

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Possible MUA or scope
« Reply #5 on: December 12, 2014, 05:58:03 PM »
i am now leaning towards the scope, but the only thing I am a little nervous about is the scar tissue. I know with the scope there is a tendency for more scar build up and that is not what I want/need. Even if the MUA is more painful, do you think that the scar tissue build up might be less? I know you are not the doctors here, but I do value your opinion.

Offline mjeffrey

  • Forum Faithful
  • ****
  • Posts: 188
  • Liked: 52
Re: Possible MUA or scope
« Reply #6 on: December 13, 2014, 04:46:34 PM »
With the LOA the surgeon should remove the existing scar tissue.

MUA will break the adhesions and then you need to hope the scar tissue is then broken down. I don't know if it is but by OS claimed that there was no more scar tissue after the MUA (didn't believe him). I did get back almost full flexion (missing 5 degrees) but my knee is still a little stiff (10 months after the initial accident).

You should read all of this Dr Noyes article on arthrofibrosis and especially this part.

http://www.kneeguru.co.uk/KNEEnotes/courses/arthrofibrosis-12-part-course-frank-noyes-md/arthroscopic-surgery-arthrofibrosis-part-7

Maybe ask the OS if he is going to remove scar tissue from everywhere that Dr Noyes mentions.

p.s. I didn't find the MUA painful (but maybe I was getting used to pain). I wrote in detail about my MUA here http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=64405.msg617327#msg617327 and it wasn't a bad experience but I think if I did it again I'd prefer a LOA in the hope of avoiding the stiffness in the knee.

good luck
Mark
2014:
20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion

Offline Scubagrl4

  • Forum Faithful
  • ****
  • Posts: 274
  • Liked: 43
Re: Possible MUA or scope
« Reply #7 on: December 14, 2014, 03:58:16 AM »
If that is what your dr. Is telling you, you are not getting accurate information. If the LOA is done correctly by a surgeon skilled in this procedure, the scar tissue will be truly removed. Anything that reforms, can be handled better with a proper PT program as the scar tissue will be new and pliable. An MUA does not remove scar tissue, so if there is a lot in there, it will either damage structures in your knee or run the risk of sticking back together. The thing that truly causes new scar tissue to form is swelling, redness, and heat in the knee. Because of this, both procedures can cause you to form more scar tissue. The true key here is finding a physician skilled in removing excess scar tissue (arthrofibrosis) properly, and a PT protocol that is designed to prevent the formation of new scar tissue.
As mjeffry said, you should read the Noyes tutorial, and other info. Posted in the arthrofibrosis section. Specifically the rehab protocol written by Dirk kokmeier and research article on rehabbing the arthrofibrotic knee by Dr. Millett. I found those the most informative. Sorry I'm not including the links, but I know they are all over the arthrofibrosis section.
A little disclaimer though, Dr. Millett is my surgeon, so maybe I am biased. But, I chose him because I wanted one of the best treating me after having a previous doc who made 5 or 6 significant mistakes that led to my problem in the first place.
So, do your research, and don't waste your time with a doc who does not have enough experience with this because time does matter.
I hope this helps...Good luck!
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases