@admins, please update to denote MUA on November 26, 2019
Warning - long post ahead!
I have seen a few posts from others regarding ROM and MUA, so wanted to share my experience. During my first 8 weeks of recovery, I struggled with knee flexion at home and during PT sessions. My flexion hovered between 75-78 and I experienced a 'hard stop' when trying to bend any further (this on my own, there was no pushing by PT). At my 6 week follow up, I raised my concerns with flexion. My OS and his colleague had a close look at my knee and determined adhesions were present. I then had a meeting with my OS and 3 of his colleagues and after much discussion, I agreed to have the MUA at 8 weeks. My OS did not promise miraculous results, but felt that I would see some improvement. I was willing to take a chance on this, as other than flexion, I was feeling pretty good - sleeping well, good balance and strength, just limited bend.
The procedure itself was quick - I was sedated and had a nerve block. The anesthesiologist warned that the back of my knee would be sore, as the block did not cover that area. He was right, but it was not unbearable. The OS took pictures and explained that there were adhesions, he had to bend my knee/leg 5-6 times to loosen. He said that the fact he could bend my knee easily afterward was a good sign, but not to expect changes overnight. He gave instructions to elevate/ice, do stretches and to attend PT twice weekly starting the following week. I was uncomfortable for a couple of days, but Tylenol took care of any pain.
The day after MUA, I went to PT to get a reading - flexion was 72 and extension 5 (had been 0). My knee was extremely swollen, so I spent Thanksgiving and the days after just resting and icing, with some light stretches.
A week after MUA, I went to OS for follow up. He prescribed a week of Prednisone followed by 200mg of Celebrex twice daily for 6 weeks. The Prednisone really reduced the swelling right away.
ROM readings in the weeks following MUA:
Week 1 post MUA: 82 flexion/4 extension
Week 2 post MUA: 85 flexion/2 extension
Week 3 post MUA: 90 flexion/0 extension - this was the week that I started to walk normally again - no hitch in my gait and better stride. My husband was first to notice, the PT folks also commented on it. It was so nice not to have to think so hard about walking anymore!
Week 4 post MUA: 95 flexion/0 extension - using my heels, I was finally able to turn the pedals forward on a recumbent bike
Week 5 post MUA: 104 flexion/0 extension - this was my final week of PT, as insurance would no longer cover.
From week 5 until now, I have been going to a local health club, where I use a recumbent bike, ARC trainer (similar to elliptical, but travels in an arc instead of rotation) and treadmill for 30 minutes total every other day. I also walk my dog a few times daily. I am unsure of how I'll do on a flight of stairs, as I live in Florida and most houses/businesses don't have many steps to navigate. My husband and I will be going to a restaurant that has a large flight of stairs this weekend, so I'll test then.
At my 6 week post MUA follow up, OS was pleased with progress. He thinks I'll eventually get to 120 or better flexion, but it will just take time. No more Celebrex and he suggested that I ice/elevate and not use Advil or Aleve unless necessary. He said I'm cleared to do whatever I want as far as exercise and activities, and but that I need to listen to my knee and not overdo.
At PT, I was shown how to measure flexion using a goniometer, but I haven't checked yet - I'm going to wait until I get to 4 months (February 1). I was able to ride my bike yesterday, but felt really shaky and couldn't turn the pedals well unless I used my heels, so I've put that aside for a few more weeks and will stay on the stationary bike.
In my case, I believe the MUA helped. I'm glad that my OS set reasonable expectations for post-MUA recovery and results. I no longer feel 'stickiness' and bumps along the incision and there is no hard stop feeling when bending my knee. There is still some swelling on the outside of my knee, but OS says that should go away with time, as tissues are still healing. My quads/hamstrings are still tight (just as they were pre TKR), so I continue to do stretches learned at PT.
United States
Stay safe and healthy xx
