What Is Manipulation Under Anesthesia?
Manipulation under anesthesia MUA has been long used for treatment of immobile, contracted joints.
It was originally proposed for treatment of frozen shoulder; however it also has indications and treatment of hip displays with limited motion, and in postsurgical knees with hypertrophic scarring.
The purpose is to take the range of motion to the maximum of the joint, overcoming and tearing the restrictive scar tissue. This is especially seen in the shoulder which can become frozen very easily when immobilized post surgery.
Total knee replacements can also develop extensive scarring around the new joint causing contracture of the muscles and soft tissues preventing normal range of motion.
Manipulation Under Anesthesia Procedure
The patient is prepared for deep sedation.
Achieving deep sedation is the key to allowing the practitioner to take the joint into full range of motion.
Often the joint is held at the peak of the range of motion for a few minutes before bringing it back to neutral.
Immediately post procedure, ice is applied to cool down the joint and decrease the pain.
Oral anti-inflammatory medications can be used.
Over the next couple of days physical therapy is employed to maintain the range of motion benefit.
The procedure is often repeated every couple of days if the post procedure evaluation determines that the range of motion is not sufficient.