Tuesday 6 March 2012

Considering Manipulation Under Anesthesia (MUA)

13 Weeks Post Op - Quad Atrophy
After three weeks on the Physio rolling program, my range of motion had increased from 48 degrees to 72 degrees and my quad muscles had finally begun to wake up and I could do a straight leg raise. I had completely ditched the support brace and had learnt to walk more confidently on crutches (I still have the zimmer frame, but only use that if I'm having a bit of a wobbly day). My leg was feeling generally stronger and my confidence was gradually coming back. It felt like progress to me, considering that less than a month before I was a dithering wreck unable to take even the tiniest step without panicking.

My physio therapist said that he would update my orthopedic doctor ahead of my six week check up the following week. When the day arrived I waited in the cubicle whilst the physio and doctor "discussed" me the other side of the curtain! Then the doctor came in to see me, saying that he'd been told I was struggling with the strength and bend in my knee and that they were considering an MUA. He explained to me that there is only a small window of time in which to carry out the MUA and its important to get it right. Wait too long and the scar tissue and adhesions may become too hardened to do the procedure effectively - do it too soon and it could cause further set backs. I don't know what these set backs are, but imagine they have something to do with muscle soreness and confidence. I'd read about MUA's on KneeGeeks so it wasn't complete news to me, I'd kind of expected that this may crop up sooner or later.

The doctor examined my knee and asked me to demonstrate the bend and a short leg raise whilst sitting in my chair. He seemed surprised to see how much I could do with it and that it was "better than the picture" he'd had from the physio. I explained to him that there had been hold ups with my commencing proper physio therapy and that I felt there had been a lot of progress generally since I'd started the program. He agreed that this seemed to be the case and said that he would have more concern if there was no progress at all in that time. He decided to give it a couple more weeks to see how things go and revisit the possibility of MUA when I next see him on 14 March.

I was fairly happy with this, it seemed like a reasonable bargain, so now its down to me to see how much I can work on the ROM and improve my quads before my next appointment. Scare tactics to make me push it more perhaps? Whatever it is, it seems to be working because by the weekend my ROM was at 80 degrees, it would be good if I can achieve 90+ by the time I see the doctor again ... but will that be enough?

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