FAQ: Why Knee Manipulation?

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When is knee manipulation needed?

Approximately 5% of patients undergoing total knee arthroplasty experience loss of motion or arthrofibrosis. Manipulation under anesthesia (MUA) is generally indicated for patients who do not achieve >90° of flexion by 6-12 weeks postoperatively. Complications from MUA are rare but can be devastating.

Is knee manipulation successful?

When knee stiffness is confirmed, it can be treated with manipulation under anesthesia, which is successful 85% of the time.

Can you walk after knee manipulation?

It is essential to regain functional range of motion by 6 weeks after surgery. Remember, patients can only reliably regain knee range of motion for the first 6 weeks following knee replacement surgery. Beyond this point, scar tissue becomes too stiff and inflexible for simple stretching to be successful.

How long does it take to recover from knee manipulation?

This is because during MUA the body undergoes a strenuous exercise session, even though the exercise is passive, performed by others. Rehabilitation should begin as soon as possible after MUA, typically within a week to 10 days, with a program of physical therapy appropriate to the individual patient.

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Is knee manipulation painful?

It is done as an overnight procedure so that a CPM machine can be used to maintain range. Once home, it is thought useful to hire a machine to use at night, so that range is not lost. Surprisingly, it is usually not painful, and it makes the knee feel freer and more normal.

How is a knee manipulation done?

During this procedure, no incisions are made. Your surgeon will position your leg in several different positions, applying pressure and breaking up the tissue. Your surgeon will be able to see and hear the tissue breaking away. Lastly, the leg will be flexed and extended to its maximum range.

How do I break up scar tissue in my knee?

Mild cases of arthrofibrosis may be resolved with intensive physical therapy alone. Other treatments include manipulation under anesthesia, when a physician manipulates the knee in a controlled fashion to break up the scar tissue. Surgery may also be an option for some patients.

Is Mua painful?

Most patients notice an immediate reduction of pain and a fuller range of motion after only one session. While some temporary muscle soreness may be experienced, it is generally equivalent to that encountered after a vigorous workout.

What does scar tissue in the knee feel like?

For some people, scar tissue may cause pain, tightness, itching, or difficulty moving. Due to the way that scar tissue matures over time, these symptoms may occur years after an injury.

What happens if MUA doesn’t work?

You can try the conservative route with exercise and manual therapy under the supervision of a physical therapist. If that doesn’t work, then surgery is advised. The surgeon must choose among three choices: 1) manipulation under anesthesia ( MUA ), 2) arthroscopic exam and debridement, and 3) open incision with revision.

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Is manipulation under anesthesia painful?

Less force is applied during the procedure making it painless and often effective. MUA is performed by trained and certified doctors who work in chiropractic medicine, rehabilitation, osteopathy, or orthopedics. It is considered to be a subspecialty which means it may not be available in every clinical office.

Is Mua considered surgery?

Manipulation under anaesthesia ( MUA ) is a minimally invasive surgical procedure which aims to relieve chronic pain and reduce the stiffness in your joints.

What degree should a knee bend?

A fully bent knee will max out at about a full range of motion of 135° degrees of flexion. As a general rule, a knee flexion of about 125° will allow you to carry out most normal activities. For daily living, a minimum flexion of around 105°-110° is required.

Why is my knee so tight after TKR?

Arthrofibrosis is also known as stiff knee syndrome. The condition sometimes occurs in a knee joint that has recently been injured. It can also occur after surgery on the knee, such as a knee replacement. Over time, scar tissue builds up inside the knee, causing the knee joint to shrink and tighten.

What do you do after knee MUA?

After the procedure, active assisted physical therapy is recommended to keep the joint flexing and retard the formation of new adhesions. A machine like the X10 can be used to help a patient regain the extension and flexion the surgeon found in the MUA.

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