What is Manipulation Under Anesthesia?

Total Knee Arthroplasty (TKA), commonly known as knee replacement surgery, is a major surgery meant to relieve pain and restore function in severely diseased or injured knee joints. While most patients achieve excellent outcomes, some may experience stiffness and limited range of motion post-surgery. In these cases, a procedure known as Manipulation Under Anesthesia (MUA) might be recommended.

What you’ll learn in this article

• Manipulation Under Anesthesia (MUA) is a procedure to improve knee range of motion by moving the joint under general anesthesia to break up scar tissue.
• MUA is considered when knee flexion remains less than 90 degrees despite extensive physical therapy and other treatments.
• Preventive steps include adhering to physical therapy, managing pain effectively, reducing swelling with ice and elevation, maintaining a healthy lifestyle, and attending regular follow-ups.
• Gradual progress in activity and avoiding overexertion are important to minimize the risk of needing MUA.

What is Manipulation Under Anesthesia (MUA)?

Manipulation Under Anesthesia is a procedure used to improve the range of motion in a knee that has become stiff after a knee replacement. During MUA, you would be placed under general anesthesia, allowing the surgeon to gently move the knee joint through its full range of motion to help break up scar tissue that may have formed and is restricting movement.

When is MUA Considered? 

MUA is typically considered if you haven’t been able to regain the expected range of motion in our knee, despite extensive physical therapy and other non-invasive treatments. Generally, if your knee flexion (bending) remains less than 90 degrees or if your knee is very stiff and making it very hard for you to move normally, MUA may be advised.

Steps to Avoid Manipulation Under Anesthesia

While MUA can be an effective treatment for knee stiffness, there are several steps patients can take to minimize the risk of requiring this procedure:

1. Adhere to Your Physical Therapy Program:
   • Consistency is Key: Follow your prescribed physical therapy regimen diligently. Exercises are designed to improve strength, flexibility, and range of motion.
   • Early Mobilization: Begin moving and exercising your knee as soon as possible after surgery, as advised by your healthcare team.
   • Home Exercises: Perform the recommended exercises at home in addition to your physical therapy sessions.
2. Pain Management:
   • Pain Control: Effective pain management is crucial for participating fully in physical therapy. Discuss pain management options with your healthcare provider to ensure you can perform exercises without excessive discomfort.
3. Swelling Reduction:
   • Ice Therapy: Apply ice packs to your knee to reduce swelling and pain.
   • Elevation: Keep your leg elevated, especially in the first few weeks after surgery, to minimize swelling.
4. Maintain a Healthy Lifestyle:
   • Balanced Diet: Consume a nutritious diet to promote healing and overall health.
   • Stay Hydrated: Adequate hydration supports recovery and muscle function.
   • Weight Management: Maintaining a healthy weight reduces stress on your knee joint.
5. Regular Follow-Up Visits:
   • Medical Check-Ups: Attend all scheduled follow-up appointments with your surgeon and physical therapist to monitor your progress and address any concerns promptly.
6. Gradual Progression:
   • Incremental Improvements: Focus on gradual increases in your activity level and range of motion rather than attempting too much too soon.
   • Avoid Overexertion: While it’s important to be active, avoid activities that might strain or damage the knee.

Conclusion

Manipulation Under Anesthesia can be a beneficial procedure for patients experiencing significant knee stiffness after Total Knee Arthroplasty. However, by adhering to a comprehensive rehabilitation plan and following the steps outlined above, patients can greatly reduce the likelihood of needing this intervention. Always communicate openly with your healthcare team and seek their guidance to ensure a smooth and successful recovery journey.