What is manipulation under anaesthesia for a stiff knee?

Manipulation under anaesthesia (MUA)

With the muscles fully relaxed under anaesthesia, the surgeon moves the knee through a controlled range, feeling the scar tissue give. No incision is made. It is most useful for loss of bending within the first few months after surgery, when the scar tissue is still relatively soft.

It is done carefully, because forcing a knee with mature, dense scar risks injuring bone, tendon or an implant.

Arthroscopic release (arthrolysis)

• Small incisions and a camera are used to cut and remove scar bands
• The pouch above the kneecap and the gutters at the sides are freed
• A cyclops nodule in front of an ACL graft can be removed to restore straightening
• Scarring around the kneecap and fat pad can be released
• It is often combined with a gentle manipulation at the end

Afterwards

The gain achieved in theatre has to be kept. Physiotherapy usually starts the same day or the next, often daily at first, with good pain control so you can move. Some patients use a machine that moves the knee passively, and night splints are sometimes used for straightening.

Most people go home the same day or after a short stay. The risks, which Dr. Gelber discusses beforehand, include bleeding into the knee, recurrence of stiffness, and rarely fracture or tendon injury with manipulation.

Deciding in Doha

At Aman Hospital, Dr. Gelber first checks for causes that need specific correction, such as a graft or implant problem or infection. He then advises which procedure suits the type and timing of your stiffness. For cost and insurance approval, check with Aman Hospital and your insurer, as these depend on the procedure and your policy.