Anyone had an MUA after a total knee replacement?

I'd like to invite @suzy240, @captjamesh, and @spinner2 to share their experiences with a manipulation after their TKR. Results can very greatly between patients due to how we form scar tissue or our individual makeup.

I had a knee replacement at age 20 due to years of damage. I developed scar tissue very quickly and had to have two MUAs as a result. The results were not the best, but in the end I got to 0-100 for my ROM. I attribute some of my lack of success to being young and not near motivated enough to take the PT seriously enough.

120 is a pretty decent ROM. Are you able to straighten your leg completely? How is your pain and your overall functionality?

I had an MUA 8 weeks post TKR. ROM 45-70. Surgeon manipulated ROM 0-125. Resulted in stress fracture of femur, bleeding from broken blood vessels and quadriceps hematoma. Could put no weight on operative leg for three weeks after. It is now 3 months post MUA. ROM 70 at best, but walking without support and finally off pain meds and driving. Before TKR, I was a very active 70 ish old. Biking, hiking, walking, serving in my church. Did everything I could possibly do in PT - just released from formal sessions this week, but continue to do it on my own. Guess I’m just not a good candidate for knee surgery. Only option I have for increased ROM (according to PTs and doctors) is arthroscopic lysis of adhesions to CAREFULLY (new surgeon) remove scar tissue and make any revision necessary, while stabilizing femur.

I’m 79 years old and am so grateful for the success of this procedure.
Yes, I can straighten my leg completely and in no pain at all.
Slow doing stairs but that might be my age!!! I can walk miles. The only problem was an unexpected infection after 12 years of no problems.
That was another operation and pt and taking an antibiotic for the rest of my life but that’s another story. Doc has no idea how this happened and it was very traumatic

Omg, I am so sorry for your loss of daily living abilities. What a horrible outcome. Thank you for sharing your experience and best wishes on getting back some quality of life. Keep working at it. A revision may help?

Going on 2 weeks out from my MUA and I’m still feeling the ramifications from the steroid injection that I objected to. Seems my body acquires every possible side effect whenever anything is introduced to it. The heart rate of +120s, sleeplessness, headaches, irritability, depression… Slowly dissipating thank God. The Drs dismiss even discussing these side effects- I was more concerned about the possibility of knee infection or systemic infections as a steroid injection halts immunity for some time. Sources differ everywhere. Seems like the surgeon focuses on mechanics and the rest doesn’t matter perhaps? The injection may be local but has huge systemic effects.

Thinking my knee is finally starting to behave like it should perhaps. It’s bending better, and doesn’t feel so tight. My extension still is not right and that impacts my gait as I still feel pain.
Will continue PT and daily exercises all the time.

Never knew how all consuming this would be. Really don’t think I can do knee # 2 no matter how it wakes me up in pain…

Hoping this MUA was the right decision. Didn’t help that it was a a big trip, lodging, food, travel… the MUA expense was part of the bundled cost “ warranty” of my total knee at least. Hmm. If I hadn’t pushed it, where would I be? The Dr only looked at #s from PT, not how stiff my knee was, or that I hadn’t progressed at all from week 6- week 11 in PT. My knee would revert back as soon as I got home.

It’s a crap shoot. We have to be our own advocates for our health. Stay informed. Read studies. Pursue second opinions…

I was happy to see the first part of your story.

The second part- infection, surgery… yikes. What happened? I was worried about getting a steroid shot during my procedure as there are studies indicating infections to the new knee and the subsequent problems. Could this been a part of your problem? Sounds like it happened later?

You sure have gone through a lot. I’m surprised you didn’t have a personal trainer pushing you for PT.

PT is concentrating on extension now as I start at 7-10 before warm up. That impedes my gait for sure. It’s still only a week and half out since MUA, so I am hoping this improves.

I can bend/ flex easier now. I get to 110* without really much effort. Getting to 120* after about an hour of PT. Hoping this too improves.

Still getting anterior pains in knee with flexion, now on left side too. We shall see.

The infection is a mystery but I wish I knew how I got it. After 12yesrs of no problems with tkr I experienced unbearable pain with chills and nausea after a wonderful day of gardening. I thought I broke something but in the er after an X-ray it was ruled out. A day later my surgeon did an aspiration to find infection. I was admitted to the hospital for surgery to replace the plastic part and infection. Spent six days there with antibiotics and pt.
For a month,I had a picc line for daily antibiotics and home pt. Now I’m taking oral antibiotics for life to keep the infection from returning.
I had many tests to see what caused the infection but all can back negative.
Now I worry about long term effects of the antibiotic but do not want infection to return. Much worse than the tkr……

Wow. How awful. The only good part of that was your mention of gardening.
I can't imagine being on antibiotics for life. My body gives me so many side effects when I take them.
Hugs.

I had my TKR in March 2023. Up to Dec 2023, I had 115 deg ROM. Then I noticed in Jan 2024 that my ROM had regressed to 85 deg. I had gone back to work and was spending 8-10 hours per workday on my feet on concrete floors. Not good. The area around the knee had become rigid and seemed like a band around the knee cap. Cycling and descending stairs was difficult. Running was OK, but I had to aware of any trip hazards because of the limited ROM. After attempts at therapy to increase my ROM, I went through MUA in July 2024. The MUA gave me an ROM of 105 deg and within several days had eased back to 95 deg (as expected by my surgeon). After the MUA, the area around the knee seemed to soften a bit and movement seemed easier. Movement is much easier and cycling is OK without much difficulty. I'm back in PT and will continue with Myofascial Release Therapy to help my ROM. I will be checking back with my surgeon in Sept. 2024. Maybe there will be another MUA in my future, but for now I will continue with PT. I'm much more optimistic with my future activity level and my therapist can also feel the difference as we work together. I thank some of the other patients in the Mayo Clinic Connect forum who mentioned Ortho-Pedals for cycling. I will be ordering one today and look forward to being able to "clip-in" soon.

Very happy you did well with the MUA! Sounds like PT will get you to where you want to be. Stay the course!