Joint stiffness can be one of the most frustrating outcomes after surgery or injury. Imagine putting in the effort to recover after a knee replacement or shoulder surgery, only to find that your joint doesn’t move as freely as it should. For many patients, this stiffness can interfere with everyday tasks, such as walking, climbing stairs, or even getting dressed. When physical therapy and non-invasive methods don’t provide the desired results, doctors may recommend a procedure called Manipulation Under Anaesthesia (MUA).

This minimally invasive technique has helped countless patients regain lost motion and return to a more active, comfortable life. In this article, we’ll dive deep into what MUA is, when it’s recommended, how it works, and what you can expect before and after the procedure.

What is Manipulation Under Anaesthesia?

Manipulation under anaesthesia is a procedure performed to improve joint mobility that has become restricted due to excessive scar tissue, adhesions, or stiffness following injury or surgery.

During MUA, the patient is placed under general or regional anaesthesia, which allows the surgeon to move the joint safely through a full range of motion without causing pain. By breaking up the internal scar tissue, mobility can often be restored significantly in just one session.

Why Does Joint Stiffness Occur?

Joint stiffness can develop for a variety of reasons. Some of the most common include:

• Post-Surgical Stiffness: Procedures such as knee replacement, hip replacement, or shoulder surgery can sometimes lead to scar tissue formation that restricts movement.
  
• Immobilisation: After fractures or ligament injuries, joints may be kept immobilised for extended periods, leading to stiffness.
  
• Inflammation and Scarring: Excessive healing responses in some patients can cause scar tissue build-up.
  

According to research, up to 6% of patients undergoing total knee replacement develop arthrofibrosis (stiffness due to scar tissue), making MUA an important option in such cases.

When is Manipulation Under Anaesthesia Recommended?

MUA isn’t the first treatment option; it’s typically considered after non-surgical methods have failed. Doctors usually recommend it when:

• Physical therapy plateaus and progress slows or stops.
  
• Range of motion is severely limited (e.g., inability to bend the knee beyond 90 degrees after replacement surgery).
  
• Daily function is compromised due to stiffness.
  
• Scar tissue is the primary cause of mobility restriction.
  

Timing is crucial. Studies show that MUAs performed within 12 weeks of joint replacement surgery are far more effective, with patients achieving greater improvements in range of motion compared to those treated later.

The Procedure: What Happens During MUA?

1. Anaesthesia – The patient is given either a general anaesthetic or a regional block so they won’t feel pain.
   
2. Manipulation – The surgeon carefully moves the joint through a full range of motion, applying controlled force to break up scar tissue.
   
3. Assessment – The surgeon evaluates the new range of motion achieved during the procedure.
   
4. Recovery Phase – The patient is awakened, and the recovery process begins immediately.
   

The procedure itself is usually quick, often lasting less than 30 minutes. Most patients go home the same day.

Benefits of MUA

• Restores mobility quickly and effectively.
  
• Avoids repeat surgery, making it a less invasive option.
  
• Enhances quality of life by allowing patients to return to normal activities.
  
• Reduces pain associated with stiffness and restricted movement.
  

In fact, clinical studies have shown that patients can regain an average of 30–40 degrees of motion after a successful knee MUA.

Risks and Considerations

Like any medical procedure, MUA does carry some risks. These include:

• Small risk of fracture due to applied force.
  
• Ligament or tendon injury in rare cases.
  
• Swelling and bruising immediately after the procedure.
  
• Risk of stiffness returning if rehabilitation isn’t followed properly.
  

Fortunately, serious complications are rare, and with proper follow-up care, most patients experience significant improvement.

Recovery After Manipulation Under Anaesthetic

Immediate Recovery

Patients often notice improvement in joint movement right after the procedure. However, the key to long-term success is early and aggressive rehabilitation.

Physical Therapy

Physical therapy usually starts within 24 hours. The focus is on maintaining and improving the range of motion gained during MUA. This may include:

• Stretching exercises
  
• Strength training
  
• Continuous passive motion (CPM) machines
  

Pain Management

Some soreness is expected, but pain is usually managed with medications, ice therapy, and gentle exercise.

Long-Term Outcomes

When combined with a dedicated rehab plan, MUA offers excellent outcomes. According to studies, up to 80–90% of patients maintain improved mobility months and years after the procedure.

Patient Experience: What It Feels Like

Patients often describe the procedure as a turning point in their recovery. For someone unable to bend their knee after replacement surgery, the sudden ability to move more freely after MUA can feel life-changing.

One patient shared in a published study that before MUA, she could only bend her knee to 70 degrees, making it nearly impossible to get in and out of a car. After MUA and several weeks of therapy, her range improved to 120 degrees, restoring her independence.

MUA for Different Joints

While knee stiffness is the most common reason for MUA, it can also be performed on other joints, such as:

• Shoulder – Often after rotator cuff repair or shoulder arthroscopy.
  
• Hip – Occasionally used after hip replacement if stiffness develops.
  
• Elbow – Following fractures or surgery that limit elbow mobility.
  

Each joint has its own recovery protocol, but the principle remains the same: break down scar tissue, restore motion, and follow up with targeted therapy.

The Importance of Choosing the Right Specialist

Like any orthopaedic treatment, the success of MUA depends greatly on the expertise of the surgeon and the rehabilitation process that follows. Patients in Perth seeking advanced orthopaedic care often turn to experienced specialists. For those considering this procedure, consulting a skilled orthopaedic surgeon Perth can provide guidance, personalised treatment plans, and reassurance about the journey to restored mobility.

Tips for Patients Considering MUA

• Don’t delay: The earlier MUA is performed after stiffness develops, the better the results.
  
• Commit to therapy: Rehabilitation is as important as the procedure itself.
  
• Stay informed: Understand the risks, benefits, and alternatives.
  
• Maintain realistic expectations: While most patients see significant improvement, outcomes vary.
  

The Bigger Picture: Restoring Quality of Life

Joint stiffness doesn’t just affect movement; it impacts independence, confidence, and overall well-being. MUA is more than a medical procedure; it’s a second chance at living life without the limitations of restricted mobility.

With careful timing, expert guidance, and dedicated rehabilitation, patients can regain the freedom to walk, bend, reach, and move with ease once again.