I had my MUA (manipulation under anesthesia) for my knee yesterday. Originally I had an open knee synovectomy on December 14th 2011 and was making good progress with my range of motion. I then underwent 17 treatments of radiation in February/March and at that time due to swelling I had to decrease my efforts in physical therapy. Radiation treatment can cause stiffness due to adhesions forming and that's what happened to me. I found that my range of motion was stuck at 81° for 3 weeks so I made an appointment with my surgeon. She told me that with hard work I would continue to make some progress but in the end I wouldn't be happy with the results.I arrived at the hospital pre op 2 hours prior to surgery and they took my medical history and started an IV. I then spoke to the anesthesiologist about getting a nerve block which numbs the knee for about 36 hours. He and the surgeon agreed that it would be a good idea since I have difficulty taking enough pain medication to control the discomfort without getting sick. Getting the nerve block does have some risks and it is momentarily uncomfortable but for me it was worth it.
They rolled me into the operating room and gave me the happy juice that knocked me out cold. The manipulation procedure only takes about 15 minutes. They just bend the knee and break up the scar tissue that has been restricting the movement. I believe she got it to 110°. If you are too ggressive there is a possibility of fracturing a bone or damaging ligaments.
I awoke in post op in a great deal of pain (tears) and they ended up giving me 2 IV doses of morphine. I didn't have any problems with the first dose but after the second injection my arm started itching bad and then my veins became engorged with blood finally hives started emerging all over my arm. At that point I remembered that when I had to inject the morphine in my port (another issue) I would get itchy. It's not an allergy but I'm getting more sensitive to it. Anyhow they gave me some IV Benedryl and that halted the reaction. Thank goodness. On a good note the morphine got the pain under control and shortly afterwards I was able to go home. I brought crutches to the hospital and since I could put weight on my leg I used them the first day as a safety measure because my knee was numb.
I had a CPM machine waiting for me at home and since my leg was quite numb I didn't have any problem going from my base of 70° to 110° max movement of the machine by morning. I spend more time in the cpm because it feels better to keep moving my knee. I didn't have to take any pain medication until about 20 hours after surgery and that's just because I want to stay on top of the discomfort as the nerve block begins to wear off.
I went to physical therapy today and my therapist said he was watching as I walked in and said that he hasn't ever seen me walk that good. For the first time since the synovectomy I was able to make full rotations on the bike. I can't tell you how exciting that was. We did another full evaluation and I could bend my knee to 107°... with his help 110° but after he worked on it for a few minutes he got it to 118°. He says that 120° is a functional goal. When I returned home from physical therapy I took some meds and strapped back into the CPM. I was very frightened to have this procedure done but I am very pleased with the results.
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