IMPE, it takes longer to heal from trauma/injury now than it did when I was young - a lot longer. I only recently regained full motion in my pinky finger after dislocating it in 2019.

What exactly is manipulation under anesthesia? What is it that you are scared of? Can you continue with PT for a bit longer?

I am assuming you are being limited by pain while you exercise? Have you tried massage? My PT does massage of some of the fiberous muscles that hold the knee. It is painful while she does it but it really helps loosen things up.

If you had your TKR the end of June, it's far too early to be talking about a MUA. Honestly, that's a common scare tactic to get patients to work "harder," which just makes the swelling and stiffness worse. I've had both mine replaced, one in 2012 and the other in 2021.

An MUA isn't surgery, it's when you're put under and your knee is bent to break up scar tissue. But you're still in the normal healing stage.

Remember too, that you're in charge. No one can force you to have a MUA.

I hate it when surgeons and therapists threaten patients with this procedure so soon in the healing process. It can take six months to get a good range of motion.

Thank you for the responses. I realize mua isn't major surgery but it still involves anesthesia. There is some amount of massage done during pt and it does seem to help some. I just feel like if I end up having to go through mua I will be back at the beginning of recovery. I am 77 and live alone. It was difficult on my family to be able to have somone here each day for the first week or so and I really don't want to have to start over again. I just started to drive again a couple of days ago although I only drive within two miles to anyplace I would need to go. Sephia, I know it is early in recovery but they scared the h... out of me. Thanks for letting me vent. I'll continue with the pt and hope for the best.

Can you try to up the amount of activity that you supposed to be doing?

I don't mean to be harsh but it is so important to stay on the plan from the beginning for the best outcome.

I would see what else can be done starting from where you are at this moment.

But, I would also try to learn more about it if the manipulation should this have to become your next step.

Satine, I don't look at you as old. You are 2 years than my DH.

I'm thinking it may be early too to be considering manipulation under anesthesia. I'm so sorry PT hasn't been more effective YET, but we heal at different rates and none too quickly at our ages. I discovered that with a simple outpatient hernia repair a couple of years ago. I'd given myself three days. Laughable now, that certainly didn't happen, I was still icing and napping at a full week out.

A friend of mine had a procedure a few months after his knee replacement (at approx 75 years old). I remember it as being fast and simple and I think that's what you are describing. They gave him light anesthetic and his surgeon manipulated his leg and knee and I think the point was loosen some scar tissue and more fully extend supporting structures in his new knee. It worked, and he continued forward with PT after that.

I understand another procedure is the last thing you want to schedule right now, but I remember this as being fast and simple for my friend and barely a bump in the road to recovery. It seemed like he was doing all his instructed exercises but of course we don't live with him so cannot say first hand. If you'd like me to ask him more about what was done, I will. But for now, I'd talk to my doctor and have all my questions including benefits to be gained answered by a pro.

I'd 'back burner' MUA. Keep at the PTwith massage. Give it time, lots of time. I think the MD's forget to factor in *age* when they spout 'range of movement expected'. As long as you are trying your best -- not babying the knee -- you'll get to where you want to be. Are you taking your pain meds well before you do your exercises? They will help you push yourself.

I've had both knees replaced and had to have the first one manipulated. Yes, you do have to be put to sleep again, but it's totally worth it. I started therapy two days after surgery with my second knee and didn't have manipulation with that one. Good luck.

If it's just rumblings, I wouldn't fret myself about it yet. How much longer are you supposed to be on PT?

I am feeling a little encouraged after hearing all your thoughts. I don't know how long I will have pt but I imagine at least several more weeks....not sure what medicare covers. Im going to keep doing my best and increase my activity at home. I typically don't take any medication except at night when I take one tylenol pm and one extrastrength tylenol. Maybe I should go back to taking it some during the day so that I am more comfortable moving around.

Take something before your PT. It helps you be able to push a little harder. I notice when I forget to take it. I do not normally take pain meds. My situation is different from yours in that I broke my leg near the knee but it comes to pretty much the same thing I would think as they took the knee apart to put it all back together. Not easy but you will get better.

I’ve not read everything but want to tell you my sister had to have this done for the same reason your doctor is suggesting it for you. Her pt got postponed too long to begin with and they needed to ”tear” the scar tissue to put her knee on the right path for healing correctly. It was so easy and from then on pt went fine and she was sble to hit the degree mark they wanted. She was very glad she had it done.

I don't have the medical expertise to advise you and I can only share my own experience and what I've observed from several close friends. I had both knees replaced when I was 61 and had intensive PT - 5 days in the hospital followed by another week as an in-patient at a re-hab center. Then another month of in-home PT and then 2 months of out-patient therapy. This was before I was on Medicare and was covered by my Blue Cross.

At one of my post-ops the surgeon cautioned that one knee was not at the level he expected and that if it didn't improve by the next visit he would schedule a MUA. That did worry me a little so I worked even harder at PT. At that time I didn't know about massage therapy to help break up scar tissue nor did any of the PTs offer it. It wasn't easy but I managed to increase the range of motion on that knee and avoided MUA.

However 2 of my close friends did have MUA and both felt it was appropriate. Six weeks post-op seems to be about the time MUA is mentioned if progress is insufficient. It isn't surgery, it wasn't painful and it allowed them to improve flexibility. You mentioned that your range of motion is barely 85. Has it plateaued at 85 or are you making consistent (albeit slow) progress?

PT helps with range of motion, balance, increasing muscle strength and circulation around the knee to reduce swelling etc. The concern is that muscles and soft tissue may atrophy due to lack of use. Deep tissue massage can really make a difference. My neighbor had her knee replaced last year and her daughter is a PT and helped with her exercises and did massage too. Ask your PT and physician about it and try to stay positive - it is hard work!

Maire

I just read your comment Maire and Im so surprised that you had time in the hospital and then time in rehab. I was only in overnight and that was only because the nerve block they administered in the or didn't take and had to be done again in recovery. I had pt at home the day after discharge and for two weeks following then to outpatient pt. I requested rehab but was told that you have to be hospitalized for three days before medicare will cover it and the doctors here don't keep you that long. I am going to request my therapist increase the time massaging as that seems to help.

satine - it was because I had both knees done at the same time which does take you out of commission for a while. I went to HSS (Hospital for Special Surgery) in NYC and that was the protocol. There were other patients there at the same tie who had one knee done and they went home the same day or stayed overnight.

I know at least 7 or 8 people who have had one knee replaced and some stayed one night, others only until the afternoon. It's important to do the exercises - are you also doing them on your own?

I admit that I have not been as vigilant as I should have been as far as exercising at home. Nobody feels worse about that than I do. I have done some most days but guess I should have pushed harder. I cant imagine having both done at once. You are one strong lady. Glad it went well for you.

Satine, don't beat yourself up. This was a big experience for you and I have a feeling you've been making your best effort so far. Now that you're feeling a little better, maybe you can try a little more diligently but don't blame yourself if you haven't quite met your goals. You WILL meet them.

My cousins husband decided to have both knees replaced same time right about the time he turned 70. A friend of theirs who is a PT tried to talk him out of it and he insisted on doing it his way. Somewhat physical and a hiker, exerciser but an atty in real life and not someone who uses their body parts all day every day.

He managed, and their marriage survived. I've always wondered how he accomplished the daily things like dressing, things taking place in the bathroom. How would one even rise from the toilet for example. They live two states away and I haven't seen them. He did have a wife at home to help but she's even a few years older than him and not King Kong ;)

You're doing fine. And you're going to reach that range of motion sooner or later. You've invested enough in this recovery already - you are not going to let it go without achieving your best outcome.

Satine - I don't necessarily see myself as strong. When I was in my 20's I had knee surgery and the surgeon told me that I would develop arthritis earlier than most people. I put it off as long as possible and decided that if the surgeon was willing to do it then I'd do both at the same time. I didn't want to give up 3 or 4 months for one knee only to repeat it again within the year.

morz- one really helpful device for rising from the commode is a raised toilet seat with handles. It made all the difference since we only had a regular height toilet and it enabled me to feel secure since DH went back to work a week after I came home. I managed with everything else, using a walker for a week or so. PT even showed me how to use the stairs while carrying a folded walker but that was only at night and DH was there to lend a hand. The hardest part was trying to get in a comfortable position in bed since I'm a side sleeper but had to lay on my back with my feet elevated for a few weeks. Oh - I didn't cook fora couple weeks - DH took care of that.

My friend had knee replacement. Since she is single, she stayed in the hospital several days and then went to rehab a week or more, where she worked hard in the special gym. Then she came home with plans to use her downstairs recliner as bed and the place to recuperate. She was always someone who could nap at the drop of a hat, that and a generous supply of pain killer prescriptions did her in. I did not realize it but she used an icing machine and napped. Finally, the home therapist discovered that all her early progress had ceased. She could move her knee only a little, so without an anesthetic, he forced her knee to bend as it should with no anesthetic, breaking all the scar tissue. She screamed as loud as she could as he bent the knee. So I see manipulation under anesthetic as a great possibility.

(((satine))) don't beat yourself up for not having been as vigilant on the exercise. You can still do those; try to do more. Even if it is only one set of each exercise. And if you have to the anesthesia route, just remember, this is something they have loads of experience doing. You'll be in good hands.

Just wanted to add that it wouldn't be full anesthesia, as in a real surgery - just a quick acting (and fairly quick out of your system) sedative and possibly a dose of painkiller. It's often called conscious sedation but you are indeed "under" - only for the length of the procedure - same as when one has a colonoscopy.

lol Raee I actually woke up during my last colonoscopy! I had pt this morning and worked with a therapist I haven't worked with before. I really liked her and she had a way of working that felt much more comfortable for me. I see her again Wed . Robb and others who have been so supportive I thank you.

if you are taking PT remember that you are in charge; don't let them tell you 'that's all' ... when you feel better ... it's getting better. Don't let them boss you around.

Who would be better to advise you, your surgeon or the internet? I would do the manipulation if it were me, then I would be vigilant in my exercise routine afterwords. It would likely be propofol, which you recover from very quickly. Yes, similar to what you would receive for a colonoscopy. Some people are just unlucky and form adhesions more quickly than others, so to avoid further adhesions it is important to be consistent with the exercises they want you to do. I would think this would be something that would be done in a procedure room, not in the OR. Good luck!

Is it possible your lack of range of motion could be from something besides scar tissue? Can they confirm you actually have scar tissue getting in the way?? I ask because I had a terrible ankle break a while back and couldn't regain full range of motion no matter how hard I worked in PT. I had MUA after a while, along with two other procedures, and never did get my ROM back. Come to find out I didn't heal properly and now have a hard stop in my ankle that prevents full ROM. So I needlessly went through that MUA and the two other surgical procedures, as well. I blame the surgeon who didn't catch that, and myself, for not getting a second opinion before the surgical procedures.