Recovering from joint surgery can be challenging. For some patients, stiffness becomes a barrier to regaining normal movement. When physiotherapy and exercises are not enough, surgeons may recommend Manipulation Under Anaesthetic (MUA).
This guide explains what MUA is, why it is used, how the procedure works, and what patients can expect during recovery.
What Is Manipulation Under Anaesthetic?
MUA is a medical procedure used to improve stiffness in joints. While under general anaesthetic, the surgeon gently moves the joint beyond its usual range to break down scar tissue and adhesions.
It is most commonly performed on:
- Knees, especially after knee replacement surgery
- Shoulders, often after rotator cuff repair
- Elbows and hips in selected cases
The goal is to restore mobility and improve function without needing further invasive surgery.
Why Is MUA Performed?
Stiffness after surgery can happen even when patients follow a proper rehabilitation plan.
Common reasons include:
- Excess scar tissue formation
- Delayed or incomplete physiotherapy
- Pain that prevents movement
- Pre-existing conditions such as diabetes or arthritis
Research shows that around 5–7% of patients undergoing knee replacement develop stiffness severe enough to require MUA.
How the Procedure Works
Step 1: Anaesthetic
The patient is given a general anaesthetic to ensure they feel no pain.
Step 2: Manipulation
The surgeon carefully bends, extends, or rotates the joint to release tight scar tissue.
Step 3: Monitoring
The joint is assessed during and after manipulation to ensure it remains stable and safe.
Step 4: Recovery
Patients often begin physiotherapy soon after to maintain the improved range of motion.
The procedure itself is short, usually lasting less than 30 minutes.
Is MUA Safe?
MUA is considered a low-risk procedure, especially when performed by experienced surgeons.
Possible risks include:
- Temporary pain or swelling
- Muscle or ligament strain
- Rare complications such as fractures (less than 0.2%)
Overall complication rates are very low, less than 1% in most studies.
What to Expect After MUA
Immediate Recovery
Patients may notice better movement right away, though some discomfort is normal. Pain relief and ice packs are often used.
Rehabilitation
The success of MUA relies heavily on physiotherapy. Daily exercises are recommended to prevent scar tissue from returning.
Return to Activities
- Driving: often within a few days
- Desk work: usually within the first week
- Sports or heavy activity: after 4–6 weeks, depending on progress
Long-Term Results
MUA has strong success rates.
- Patients typically gain 30–40 degrees of additional motion in the knee.
- More than 80% report meaningful improvements in daily function.
- Quality of life scores rise significantly within three months.
Those who remain committed to physiotherapy usually achieve the best outcomes.
Alternatives to MUA
Not every patient is suited for this procedure. Alternatives include:
- Arthroscopic scar tissue removal
- Revision surgery for mechanical issues
- Extended physiotherapy with advanced techniques such as hydrotherapy or electrical stimulation
Key Statistics
- Over 65,000 knee replacements are performed in Australia each year.
- 5–7% of patients require MUA for stiffness.
- More than 80% of patients report improved mobility after MUA.
- Risk of major complications: less than 1%.
Preparing for the Procedure
Patients preparing for MUA should:
- Share their full medical history with their surgeon
- Plan for support at home during early recovery
- Commit to physiotherapy immediately after the procedure.
Final Thoughts
Manipulation under Anaesthetic is a proven and effective option for patients struggling with stiffness after joint surgery. When combined with dedicated physiotherapy, it helps restore mobility and independence.
If you are experiencing limited movement after surgery, experienced Perth orthopaedic surgeons can guide you through the right treatment plan and help you achieve lasting recovery.