manipulation questions

[leecompton1]

I had a ltkr approx. 20 months ago. My OS up to about 5 months ago kept telling me it takes 18 months for complete healing every time I would complain about stiffness, pain and lack of mobility. I finally woke up and gave up on him. Currently I’m lucky to get 90 degrees, the more I walk the stiffer it gets and more pain sets in. I’ve given up bike riding (can’t keep my foot on the pedal it won’t bend), can’t go down stairs, swimming is gone, getting down on the floor and up is a real project just to mention a few. My question is this. I visited a new doctor yesterday (this is #4) and he said the “hardware” all looks good but he suggested manipulation.
Has anyone had manipulation this late in the game?
Does it hold any benefits this late in the game?
How do they know they are really breaking up scar tissue?
Of course he told me that it is beneficial, but I was hoping to get some opions of others that are familiar with it. Any advice would be greatfully appriciated.

 

[lissa]

I had a ltkr approx. 20 months ago. My OS up to about 5 months ago kept telling me it takes 18 months for complete healing every time I would complain about stiffness, pain and lack of mobility. I finally woke up and gave up on him. Currently I’m lucky to get 90 degrees, the more I walk the stiffer it gets and more pain sets in. I’ve given up bike riding (can’t keep my foot on the pedal it won’t bend), can’t go down stairs, swimming is gone, getting down on the floor and up is a real project just to mention a few. My question is this. I visited a new doctor yesterday (this is #4) and he said the “hardware” all looks good but he suggested manipulation.
Has anyone had manipulation this late in the game?
Does it hold any benefits this late in the game?
How do they know they are really breaking up scar tissue?
Of course he told me that it is beneficial, but I was hoping to get some opions of others that are familiar with it. Any advice would be greatfully appriciated.

I understand its like going back to surgery, they don't cut, but do some serious bneding to break up the scar tissue. It's not much fun,,,BUT at 20 months to onlt have 90 degrees...not to be doing just nrmal wlaking, swimming etc. would be a no brainer...rhink you should have gone back to surgeon a long long time ago..but now is now..get a couple of opinions, but do something..and do it sooner than later...no way you should be stuck as you are!

 

[calling_all_angels]

Yes it is a good thing if it is scar tissue that is holding you back. Only at this late in the game I think I would ask if a scope would not be better then a MUA. Please let me know what he says.

 

[Texas]

Yes I wil look around but someone here just have a MAU far out and it was ok. I had one and it worked I was sore but wow what a difference I could only bend 68 when he was done though and after a lil PT I got to 126 but you know what PT was so much easier I didn't have to cry and struggle. If there is a lil of scar tissue it is sooooooo worht it you really will feel the difference. And right now I would do it , it certainly cant hurt . I cant believe your other Dr left you like that its terrible.When are you having it done...It is sore now being so far out it might be more sore but really it is worth it.....Good Luck to you I hope you gt the bend you DESERVE............He actually bent my leg during the MAU to 139. Im getting there but it is easier now thats for sure.....AND NO MORE TEARS!!!!!!!!!
Calling might be right but I don know about the scopes, But I know its done....

 

[Josephine]

Well, it's unusual to say the least but it has been done. No point in not trying it.

How do they now they're really breaking up scar tissue? I suppose you've been reading around and found that one of the risks of MUA is breaking the femur? Well, theoretically, this is true but if it's any reassurance, in my lifetime I've seen hundreds of MUAs and never once known one result in a fracture. Thing is, the surgeon knows how much pressure he can safely apply. And another is that the femur is incredibly difficult to break with one's bare hands. So the risk is mostly a theoretical one. I can assure you of that.

The other risk is, as you suspect, that the adhesions might be so set that it won't achieve anything. That's the worst case scenario though. I think it will give you some improvement but how much you'll not know till it's done. Sadly it does happen that some people end up with a stiff knee and nobody really knows why.

However, I do think it was very remiss of your first surgeon to leave it so long. If it was me, I'd be tempted to think about legal action. But see how this turns out first.

If you want to know more about adhesions (scar tissue) and why they happen, you can look here MUA (manipulation under anaesthetic) and adhesions

 

[loribee59]

I made the mistake of waiting too long to get MUA with my left knee. Even with a 2nd opinion, the doctors don't want to mess with it, considering my doctor had a bad experience manipulating a 75 year old woman's knee and ended up breaking her leg in the process of it. They're pretty gun-shy where old surgery/scars are concerned.

HOWEVER.....I found a chiropractor who does ART therapy; where deep tissue massages release the scar tissues/adhesions...it's not an overnight miracle--but it does make a difference. After 3-4 months of this therapy, my knee isn't as stiff and I'm still sore where I can't bend, but I'm getting close to getting 90° ROM.

broken link removed: https://www.activerelease.com/what_patients.asp

broken link removed: https://www.activerelease.com/providersearch.asp

if I were you....I'd try the ART therapy, but in the meantime, keep asking around and hopefully you can find a doctor who is willing to do manipulation on old surgery/scar tissues. Because, by the time you have your scar tissues worked on, it might be easier to do a manipulation.

Something to think about...

 

[loggon]

What about a scope opr. They maybe able to do that.

I do hope you do great. And as Jo said, you might want to think legal. Wow 20 months a long time.

 

[loribee59]

How do they now they're really breaking up scar tissue? I suppose you've been reading around and found that one of the risks of MUA is breaking the femur? Well, theoretically, this is true but if it's any reassurance, in my lifetime I've seen hundreds of MUAs and never once known one result in a fracture. Thing is, the surgeon knows how much pressure he can safely apply. And another is that the femur is incredibly difficult to break with one's bare hands. So the risk is mostly a theoretical one. I can assure you of that.

The other risk is, as you suspect, that the adhesions might be so set that it won't achieve anything. That's the worst case scenario though. I think it will give you some improvement but how much you'll not know till it's done. Sadly it does happen that some people end up with a stiff knee and nobody really knows why.

y'know, Jo....I might re-consider bugging the heck out of a couple of doctors to see if they can't do a MUA for my left knee.... that comment you made about how hard it is to break a leg like that gives me a little bit of hope. Maybe I might find a doctor who's willing to do it for me. did I ever tell you you're an absolute doll?! :wub:

 

[Josephine]

That's interesting about ART, loribee. I must look into that.

I mention about how hard it is to break a bone with the bare hands because I've tried it! A firm runs workshops for doctors and nurses on how to use screws and plates on fractures. Nowadays they use plastic bones but years ago, we used to use real human cadaver bones! :euw: But we had to break the bones with a hammer and chisel in order to make a fracture to fix. We had the bone in a vice and a lump hammer (i.e. heavy!) but it seemed no matter how hard we worked at it, the bone just would not break! The surgeons had the same and when I spoke with the surgeons I was working with at the time, they all agreed that it was very difficult to break it even with a lump hammer and a chisel. However, some surgeons can have more brute strength than sense so choose your surgeon carefully!

 

[loribee59]

What about a scope opr. They maybe able to do that.

I do hope you do great. And as Jo said, you might want to think legal. Wow 20 months a long time.

My left knee's been at 90° for 24 months. After I get my right knee done, I hope to get up to over 90° before the 6 weeks is up....my doctor threatened MUA if I don't get that 90° ROM! yikes! I love him dearly...and he's CUTE too! *sigh* too bad he's married... :wub:

 

[Motherofmany]

Hi,

Just thought I'd add my 2 cents here. I've had problems with my ROM, had a MUA and am still struggling to increase. I am trying several things:

1. Pool therapy (helping improve my gait and ROM also feels great and fun)

2. Physical Therapy for 4 weeks, using gentle stretching.

3. Massage Therapy using this technique https://mrtherapy.com/ My massage therapist gave me the book below and I'm trying their method, holding the stretches for only 2 seconds. Read the article to follow with the link on #4 to answer questions.

4. The Whartons' Stretch Book with Active-Isolated Stretching. https://www.npr.org/templates/story/story.php?storyId=5601280

I am motivated to get this knee moving and on with life. With the pending LTKR, I need more ROM faster than I'm getting it on my own, so I'm open for suggestions and trying multiple treatments hoping for the best.

Maybe one of these will work for you too!

Blessings,

 

[skigirl]

Don't forget leecompton that if you do get a MUA, there should be lots of therapy immediately afterward to help keep whatever ROM that you achieve. At my clinic they do therapy five days a week for two weeks after a MUA. I agree with Jo about your first doc--I would talk to a lawyer--because he did not even help you get to a functional rom--and that is criminal.

 

[leecompton1]

Everyone -
Thanks for all the information and support. I'm writing down a load of questions to meet with the doctor again. But all your advice has surely helped me and put me a little more at easy. Thanks again everyone!

 

[jayno]

I had a mua 4 months after my knee replacement. Did not help me much so they did arthroscopic surgery to remove scar tissue the following month. That helped more than mua but my knee is still not right. You might get good results with yours but I wish you the best of luck and hope everything goes well for you.