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MUA Festina lente -Hastening slowly

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Update: I had my final appointment with the OS today. He's very happy with my progress as am I. My surgeon said that he could feel and hear the underlying tissue rip. Nice! He said that MUAs are a 'well trodden path' these days but that he is more cautious about timing than some surgeons.

The red flag for him is 60 degrees or less at 6 weeks but waits till 11/12 weeks to see if there's improvement. I asked if there was anything I could have done to prevent the development of my adhesions/scarring and he said I'd done everything possible but some people have a propensity to develop it.

If I have my other knee replaced it may or may not happen again. He'd seen both outcomes. All in all I was very satisfied with my outcome, his and the hospital's care and with his clear explanations. I was glad I'd gone to a surgeon with such a wealth of experience behind him.
 
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Great recap thanks Spex10. It was helpful info for me. Good to hear that your OS is happy with your progress. When was your TKR and your MUA again?
 
Never mind. I now see the October and January dates which are both very close to mine. How is your pain and stiffness levels? Mine are still bothersomely significant. Had an x-ray earlier this week that did not indicate that anything is amiss.
 
Pain and stiffness is OK. Its not absent but is at acceptable levels. No painkillers required. The more I move around the easier it gets. If I sit for too long or have my feet up for too long its a bit sore when I change position. I've noticed a sort of quantum leap in the last week. Suddenly, I don't need my stick when I'm out and a friend who I've not seen for a while spontaneously said how much better I was walking.
I should say that I don't lead a very sporty or outdoors life. I don't have to shovel snow. I'm a writer and do author events so I really only need my hands for the keyboard and my ever open mouth for the talks!
 
@Spex10, I am one of those that tried to talk you out of a MUA. It is obvious that I was quite wrong. My reason was reading so many other posts who's PTs or OSs had threatened a MUA very early in their patient's recovery. Some as early as in the hospital right after their surgery! Your OS in not one of those! You have taught us all that sometimes a MUA is needed and will be very beneficial. I applaud your decision and rejoice with you in your success!
 
Wow, Spex, that`s great news! That`s really interesting to hear what your OS said. I`m chuffed to bits for you! SA seems even nearer now!
 
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Excellent, @Spex10 !!!! The decision to have an MUA has to be a difficult one - there is so much 'unknown' in this entire knee recovery process, that it's hard to predict the future. It makes me think of those poor souls who have mastectomies as a preventative effort against breast cancer. If you have an indication, I don't think it's a poor choice to take preventative measures - especially if the consequences of NOT doing so down the line are worse.

That's kind of how I see MUA. I'm sure it's not a walk in the park, or pleasant....but they do exist as a medical procedure, because they must help some people. I look at the spine surgeries that I monitor, and know that a certain percentage of people will wake up and not be 'fixed' for whatever reason. When I went in to have my knee scoped 3 years ago, we were hoping to repair my meniscus. When I woke up, I found out it was all for naught, and that nothing (other than 'cleaning me out') was actually done. Bottom line is that sometimes we have to take the gamble that the procedure *will* work for us. I'm really glad you did, because it seems to have helped you greatly!

My first exposure to MUA (before I knew it was even called a manipulation under anesthesia) was talking to one of the girls in my alanon group who had a knee replacement by my surgeon. She said that at 3 months the surgeon suggested MUA, but she waited until 6 months just in case. When they did the MUA, apparently the tissue was hardened/stiff/whatever enough that it actually broke her femur when they bent her leg. He ended up having to do an emergency repair. She has an autoimmune disorder, so likely her bone was not as strong as some....but you have to wonder if she had it at 3 months, would it have resulted in the same thing?

Regardless, she was thrilled she had hers even though she woke up with a broken femur! So I think it's kind of a personal decision. I did meet a lady in PT who had a really horrible propensity toward developing scar tissue - she had 2 MUA, and 2 revisions, and still only had 20-30 degrees of bend. She actually went back to get her other knee done, and was in PT (with me) for the second one. So many different outcomes for different people, as evidenced by those on these boards who *have* had MUA, and those who have waited for their ROM, and been successful.

I'm ecstatic you are happy and doing well. Although I'm going to miss all the stories about pedaling naked on the loo. And I promise that if I ever come out your way, I'll make sure to stay at a 5 star hotel with many luxury bathrooms, so as to spare you any wilderness toilet-ing! :hiking: Trust me - I'm all for luxury living, too. A relaxing spa day and pampering in an upscale restaurant aren't such a bad thing either! A little diversity never hurt anyone :martini:
 
Wonderful news that the MUA worked and you are doing so much better! That is great information from your OS..thank you for sharing:)
 
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