Manipulation

Overview
Also known as Manipulation Under Anesthesia or MUA.

If the knee joint lacks mobility or is completely frozen a few weeks after surgery, a doctor may call for a manipulation, in which the patient is placed under a general anesthetic and the doctor forces the knee joint to move, breaking apart any scar tissue that has formed.

Detailed Description
Specialist
Orthopedic surgeon

Procedure
Before the procedure: testing of range of motion, application of general anesthetic.

During the procedure: Manipulation is one of the more primitive—but sometimes necessary—procedures in knee rehabilitation. After putting the patient under, the doctor proceeds to pull, bend, twist, and otherwise mobilize the knee joint to break up any scar tissue that has formed. More recently, doctors have been using an arthroscope before the procedure to remove any evident scar tissue before performing the manipulation, which increases its effectiveness and lessens the risks. The need for manipulations has decreased since the advent of the Continuous Passive Motion machine, which inhibits the ability of scar tissue to form.

After the procedure: physical therapy, testing of range of motion.

Timing
Generally two to three weeks after surgery, as needed.

Complications/Risks

• In patients with completely frozen knees, whose bones may have weakened, manipulation raises the risk of breakage in the femur or tibia.
  
• Blood clots
  
• Nerve or blood vessel injury during surgery
  
• Hemarthrosis, or blood inside the joint
  
• Soreness

Last updated: 26-Oct-01