Knee and joint stiffness can be frustrating. Imagine going through surgery, expecting to regain full mobility, only to find that your joint feels locked or painfully restricted. For many patients, this is where Manipulation Under Anaesthetic (MUA) becomes an important treatment option.
This guide explains everything you need to know about MUA what it is, when it’s recommended, how the procedure is done, what recovery looks like, and the risks involved.
What Is Manipulation Under Anaesthetic (MUA)?
Manipulation Under Anaesthetic is a non-invasive medical procedure where a stiff joint is gently forced through its range of motion while the patient is under anaesthesia.
Because the patient is asleep and pain-free, the surgeon can safely stretch the joint, break down scar tissue, and improve movement without resistance.
It’s most commonly used for:
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Stiff knees after knee replacement surgery
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Frozen shoulder (adhesive capsulitis)
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Stiffness after trauma or prolonged immobility
Why Is MUA Performed?
Even with excellent surgery and diligent physiotherapy, scar tissue can form inside a joint. This scar tissue limits motion and makes recovery difficult.
Common Reasons for MUA:
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After Knee Replacement: Up to 5% of patients develop stiffness that limits bending or straightening.
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Frozen Shoulder: Affects about 2–5% of the population, with higher incidence in people aged 40–60.
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Post-Traumatic Stiffness: Injuries sometimes lead to restricted joint movement despite healing.
When traditional treatments like physiotherapy or anti-inflammatory medications don’t provide relief, MUA becomes a practical option.
Benefits of MUA
The main goal of MUA is to restore joint mobility and reduce pain. Patients often notice improvement almost immediately after the procedure.
Key Benefits Include:
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Increased range of motion
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Reduced stiffness
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Faster rehabilitation progress
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Avoidance of more invasive revision surgeries
For many, MUA offers a second chance at recovery when the initial path hasn’t gone as planned.
Preparing for Manipulation Under Anaesthetic
Preparation for MUA is similar to other short surgical procedures.
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Pre-Assessment: Your surgeon will evaluate your medical history and check for conditions like clotting disorders or infections.
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Imaging Tests: X-rays or MRIs may be ordered to assess the joint.
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Medications: Some medicines (like blood thinners) may need to be stopped beforehand.
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Fasting: Patients are generally advised not to eat or drink several hours before anaesthesia.
Good preparation ensures the procedure is safe and effective.
The Procedure: Step by Step
MUA is usually performed as a day procedure. Here’s how it typically works:
Step 1: Anaesthesia
The patient is given general or regional anaesthesia to ensure comfort and prevent pain.
Step 2: Gentle Manipulation
The surgeon carefully bends, stretches, and moves the joint through its range of motion. Scar tissue that limits mobility is gently broken.
Step 3: Monitoring
The joint is checked for improvement in flexibility. Sometimes additional injections (like steroids) are given to reduce inflammation.
Step 4: Recovery
The patient is moved to recovery and monitored as the anaesthesia wears off.
The whole process usually takes less than 30 minutes.
What to Expect After MUA
Recovery doesn’t end once the procedure is done. In fact, rehabilitation after MUA is the most important part of ensuring long-term results.
Early Phase (First Few Days)
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Icing and pain relief medications may be prescribed.
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Physiotherapy usually begins immediately to maintain the improved motion.
Mid-Phase (2–6 Weeks)
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Regular physiotherapy continues.
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Patients focus on stretching and strengthening exercises.
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Most patients regain significant motion within weeks.
Long-Term (3 Months and Beyond)
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With commitment to physiotherapy, long-term mobility can be restored.
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Studies show that 80–90% of patients experience significant functional improvement after MUA.
Risks and Complications
While MUA is considered safe, as with any procedure, there are risks.
Possible Complications Include:
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Small fractures (rare, less than 1%)
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Ligament or tendon injury
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Reformation of scar tissue if physiotherapy is not followed
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Anaesthesia-related risks
Fortunately, serious complications are uncommon, and most patients benefit greatly from the procedure.
Real-World Statistics
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According to a study in The Journal of Arthroplasty, patients who undergo MUA within 12 weeks of knee replacement surgery see better results compared to those who delay treatment.
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Success rates for frozen shoulder MUA are reported to be up to 80% in improving mobility and reducing pain.
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Australian orthopaedic data shows that early intervention and consistent physiotherapy post-MUA lead to the best long-term outcomes.
Role of the Orthopaedic Surgeon
The expertise of your surgeon is crucial. An experienced orthopaedic specialist knows when to recommend MUA, how much force to apply during manipulation, and how to guide recovery.
Patients often ask, “How do I know if this is the right procedure for me?” The answer lies in having an honest conversation with your specialist, reviewing your progress, and assessing the risks versus the benefits.
When it comes to procedures like this, experienced orthopaedic surgeons perth provide the skill and judgment necessary to ensure the best outcome.
Life After MUA: Patient Tips
To make the most out of the procedure, patients should:
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Commit to physiotherapy sessions.
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Perform home exercises daily.
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Stay active but avoid overloading the joint too soon.
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Maintain a healthy weight to reduce joint stress.
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Follow-up regularly with their surgeon.
Consistency is key without it, stiffness can return.
Conclusion
Manipulation Under Anaesthetic offers a powerful solution for patients struggling with joint stiffness after surgery or injury. It’s quick, minimally invasive, and highly effective when paired with physiotherapy.
For those who feel frustrated by limited progress after joint surgery, MUA may provide the breakthrough needed for better mobility, reduced pain, and improved quality of life.
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