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Knee Manipulation Under Anesthesia: Recovery Time and Tips


Treating joint pain often requires surgery, which can be a lengthy and challenging process. One surgery that is sometimes used to treat joint pain is knee manipulation under anesthesia (MUA). A couple of common questions asked on this topic are what is a knee manipulation surgery and what is the knee manipulation under anesthesia recovery time

MUA is a type of arthroscopic surgery that involves temporarily immobilizing the knee joint and manipulating it into place. This procedure is often used to treat conditions such as knee pain, arthritis, and joint stiffness.

MUA is generally a safe and effective procedure, but some risks are involved. The success rates for MUA are about 80-85 percent. The most common complications are temporary and include bleeding, bruising, and pain. In rare cases, more serious complications can occur, such as infection or nerve damage.

Recovery time after MUA surgery can vary depending on the individual, but it is typically relatively short, according to the current study.  In this article, we will discuss the conditions you may treat with MUA surgery, the risks and benefits of the procedure, and what to expect in terms of recovery time.

Conditions that May Require MUA:

MUA is often used to treat several different conditions that cause knee pain from primary total knee arthroplasty to non-invasive procedures. These conditions include:


Arthritis is a common condition that causes inflammation and pain in the joints. There are many different types of arthritis, but MUA is often used to treat osteoarthritis. This is the most common type of arthritis, and it is caused by the wear and tear of the cartilage that cushions the joints.

Joint Stiffness:

Joint stiffness is a common symptom of arthritis. It can also be caused by other conditions, such as bursitis or tendinitis. Knee stiffness can make it difficult for degrees of knee flexion and can be painful.

Knee Pain:

Knee pain is a common problem that can severely limit mobility and quality of life. If you are experiencing chronic pain, your doctor may recommend manipulation under anesthesia (MUA) as a treatment option after a systemic review.

The Procedure for Knee MUA:

MUA is a minimally invasive surgery, which means that it is performed through small incisions.  MUA is typically performed as an outpatient procedure, meaning you will not have to stay in the hospital overnight. These surgical techniques usually take less than an hour, and you will be given general anesthesia to keep you comfortable during the procedure.

The surgeon will make one or two small incisions in the skin around the knee. A thin, flexible tube called an arthroscope would be inserted into the knee joint.  The arthroscope has a light and a camera on the end, which allows the orthopedic surgeon to see inside the knee joint. The surgeon will also insert other surgical instruments through the incisions.

The surgeon will then use these instruments to manipulate the knee joint into the correct position. The manipulation may involve moving the bones, tendons, fibrous adhesions, or ligaments around the knee joint.  Internal scar tissue that has formed around the joint may also be removed.

After the knee joint has been manipulated into the correct position, the surgical procedures demand the placing of a splint or cast on the leg to keep the joint in place. 

Hospital staff will take you to a recovery room where doctors will closely monitor you.  Once you awake and your blood pressure, heart rate, and breathing are stable, you can go home.

Knee Manipulation Under Anesthesia Recovery Time

The patient first questions the length of time it takes to recover from MUA surgery. In most cases, people can return to their normal activities within a few days.

Keeping the knee joint immobilized for a better outcome in the first 24 hours after surgery is important. This means you should not put any weight on your leg or bend your knee. You may need crutches or a walker to help you get around during this time.

After the first 24 hours, you can slowly start putting weight on your leg and bending your knee.  Then, you will be able to resume your normal activities gradually.

Most people can return to work within a week or two. However, it may take longer for some people to feel completely back to normal. You should avoid strenuous activities, such as running or playing sports, for at least four to six weeks.


Recovery and Rehabilitation after MUA Procedure

Rehabilitation is an integral part of the recovery process after MUA for total knee replacement surgery or partial knee replacement. The goal of rehabilitation is to help you significant gains in strength and knee range of motion.

Your orthopaedic surgeon will likely give you a specific rehabilitation program to follow. This program will likely include:

Physical therapy:

You will probably need to go to aggressive physical therapy twice a week for several weeks. Your physical therapist will teach you exercises to help strengthen the quadriceps muscle around your knee joint.

Range-of-motion exercises:

You will likely need to do knee motion exercises several times a day. These adequate range of motion exercises will help increase your knee joint’s flexibility and full extension.


You may need to ice your knee for 20 minutes several times daily. This will help reduce swelling and pain around the knee joint.


You may need to wear a knee brace for several weeks after surgery. This will help stabilize the knee joint as it heals.

You should avoid strenuous activities, such as jogging or playing tennis, for the first four to six weeks. 

Possible Risk Factors and Complications of MUA:


Any time surgery is performed, there is a risk of infection.   The risk of infection following knee manipulation under anesthesia is very low. However, it is still possible. Symptoms of infection include redness, swelling, warmth, and drainage from the incision site.

It is essential to follow your surgeon’s instructions to prevent infection, such as taking antibiotics and keeping the incisions clean and dry. If you experience any of these symptoms, please contact your doctor immediately.

Blood Clots:

Another possible complication of late MUA groups is the formation of blood clots. Blood clots can form in the leg or lung and can be dangerous. Symptoms of a blood clot include pain, swelling, and redness in the leg; shortness of breath; and chest pain.

You can minimize the risk of blood clots by getting up and moving around as soon as possible after surgery. You should take prescription medication to help prevent clots from forming.

Nerve or Blood Vessel Injury:

In the worst case, the nerves or blood vessels around the knee can be injured during MUA surgery. Symptoms of nerve or blood vessel injury include numbness, tingling, and weakness in the leg. 

Most nerve and blood vessel injuries are temporary and will improve on their own with time. However, in some cases, surgery may be necessary to repair the damage.


 Arthrofibrosis is a condition that can occur after any joint surgery. It occurs when scar tissue forms around the joint, making a knee extension deficit. Arthrofibrosis is more likely to occur after MUA surgery if you already have a stiff knee or if you have had a previous operation on that joint.

Arthrofibrosis can be treated with physical therapy, injections, or, in rare cases, surgery.

Overall, MUA is a safe and effective procedure. However, as with any surgery, there are risks and complications involved. Be sure to talk to your surgeon about these risks before having the procedure.


Contraindications for MUA:

Certain medical conditions may make MUA surgery a risky proposition. These conditions include:


If you have an infection in or around the knee joint, MUA surgery may not be an option. The infection will need to be resolved before surgery can be performed.  This is because joint manipulation during MUA surgery can spread the infection to other body parts.

Arterial Disease:

Atherosclerosis, or hardening of the arteries, is a condition that can contraindicate MUA surgery. MUA surgery involves manipulating the blood vessels around the knee joint.

The arterial disease can reduce blood flow to the leg, leading to surgery complications. If you have arterial disease, your surgeon may recommend another conservative treatment option, such as physical therapy.

Venous Disease:

Venous disease can also make MUA surgery a risky proposition. The venous disease reduces blood flow from the leg, making it more difficult for the incisions to heal. Other options, such as arthroscopic surgery, may be more appropriate for low-demand patients with venous disease.

If you have venous disease, your surgeon will likely recommend that you undergo a procedure to improve blood flow to the leg before having MUA surgery.  

Bleeding Disorders:

Patients with bleeding disorders like hemophilia may not be candidates for MUA surgery. This is because the manipulation of the joint during MUA surgery can cause excessive bleeding.

These disorders can make it difficult for the blood to clot, which can lead to excessive bleeding during and after knee surgery.


Pregnant women are not recommended to have MUA surgery. The medical procedure can cause contractions and put the baby at risk.

Cardiac Conditions:

MUA surgery is not recommended for a patient’s condition with certain cardiac issues, such as heart failure. These chronic conditions can increase the risk of complications from MUA surgery, such as arrhythmias and chest pain.

MUA surgery is a safe and effective procedure for treating knee pain. However, there are some risks involved.

If you have any medical conditions listed above, MUA surgery may not be an option for you. Talk to your doctor about your options for MUA treatments.  MUA surgery is not recommended for pregnant women or patients with certain medical conditions. Be sure to talk to your doctor about these risks before having the procedure.


Knee manipulation under anesthesia is a procedure that can help relieve pain and improve function in people with knee problems. The recovery time from this procedure is typically short, and most people can return to their everyday activities within a few days.

Some risks are associated with the procedure, but these are usually minor and can be effectively managed with proper medical care. If you are considering this procedure, discuss the risks and benefits with your doctor to ensure it is the appropriate treatment.

We hope you learned more about knee manipulation under anesthesia recovery times, and all other aspects of this procedure.