MUA Scheduled for MUA

[SSC]

I had TKA on L on March 11. Was not able to gain any ROM, with Home PT, then started Clinic PT. Saw my Dr., and now scheduled for a MUA in 3 days. Hoping for the best, will be doing PT 3x a week for 6 weeks. Any help would be greatly appreciated! Thanks.

 

[Jockette]

@SSC Hi and Welcome!

I’m sorry to read you are scheduled for an MUA, so early in recovery. Many times we just need more time to heal, and adjustments made to reduce our rehab exercise routine, to avoid an MUA. Overworking the knee can maintain and/or increase our swelling, which will prevent ROM from increasing. Sometime doctors and PTs are impatient and don’t allow us to heal on our body’s own timeframe.

What is your ROM and what are you doing in PT and at home?

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

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4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[SSC]

Good morning, well yesterday was interesting. I went to PT, and had exercises. The knee itself did not hurt, but I had bruising on upper thigh and lower leg, probably by the Dr. He had come out to my wife after the MUA and showed her a picture after the procedure. Good 120 degree bend. Was told to go home and take it easy first day. Then PT. Was put on a pretty strong Prednisone regimen for swelling. Could only get 84 degrees yesterday. I did another round of exercises as prescribed by the PT yesterday . I've got 6 weeks of PT 3x per week. Yesterday my wife measured me and seemed like I did obtain 90 degrees. I'm a mechanic and thought maybe that may encourage me. The Dr. called to check on progress, he did mention if I didn't make progress they may consider a scraping out of scar tissue. I guess we'll see. BTW, this was a lateral incision, done by one of the docs that halfway had something to do with it's invention. Really loved that!

 

[benne68]

@SSC -- I've updated your signature and want to confirm that your MUA was April 24. Also, which knee was the surgery?

 

[benne68]

Please take things slowly, @SSC. Your leg needs time to recover from the trauma associated with that MUA. For many patients, it is like setting back your recover to day one.

You are still very early days and need to allow the swelling to go down. As long as there is inflammation inside the knee (even if you can't see it on the outside), it will restrict your bend. Please give it time.

 

[mendogal]

Based on what we know about soft tissue healing and the development of scar tissue, it's more likely that swelling by over-working your knee was interfering with your range of motion than it was scar tissue.

There is a small subset of humans who for unknown reasons grow lots of scar tissue following any surgery at all.
However inflammation and swelling is 100% a normal part of the initial healing process, and because the knee joint has very little empty space, even mild or not-visible swelling prevents the flexion.

In our experience, elevation and ice at least 45 minutes at a time relieves pain and swelling. Walking every hour and gentle range of motion without forcing the joint allows for the return of function.

This is an excellent article on Adhesions and MUAs.

 

[maryo52]

I can only speak for myself. I had terrible arthrofibrosis which PT never helped (and, honestly, I think it might've contributed to the arthrofibrosis). I had a MUA and for the first time could sit on the side of the stretcher and dangle that leg. But in three days it was clearly regressing. Lots of PT, no improvement. And all those efforts trying to bend a knee that didn't want to bend caused a lot of pain! Finally I underwent arthroscopic lysis of the scar tissue, after which I refused PT. What I did do was get hold of a knee bending machine and use that while watching TV figuring it made my knee a moving target for scar tissue. And I would use an exercise ball and would sit on it and slowly roll forward and bend that knee to the point of pressure but not pain. I did slow movements and would hold the bend for 10 seconds and maybe do five of those, twice a day. It took a few weeks but I finally made it past 90 degrees and got to 120 ultimately. When that knee was later revised I could tell that if it was pushed it would scar up again so I did a very gentle routine of one or two bends daily and had no issue whatsoever. The PT expressed concern about my knee being slow to acquire good range of motion so I called off the PT, problem solved.