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Manipulation under anesthesia (MUA) or fibrosis release procedures [1] is a noninvasive procedure to treat chronic pain which has been unmanageable by other methods. MUA is designed not only to relieve pain, but also to break up excessive scar tissue.
In the case of AF after total knee arthroplasty (TKA) management traditionally consisted of aggressive physical therapy, and in the case that failed, manipulation under anesthesia (MUA). As discussed above, aggressive exercise is now avoided. The rates of MUA after TKA vary widely.
Michael J. Bronson is an American orthopaedic surgeon who is Chairman of the Department of Orthopedic Surgery, Mount Sinai West and Mount Sinai Morningside, and Chief of Joint Replacement Surgery at the Icahn School of Medicine at Mount Sinai in New York, and the author of advances in the development of minimally invasive surgical instruments to advance unicondylar partial knee replacement, [1 ...
Most contraindications apply to the manipulation of the affected region. [63] While safety has been debated, [3] and serious injuries and deaths can occur and may be under-reported, [4] these are generally rare and spinal manipulation is relatively safe [46] when employed skillfully and appropriately. [5]
Many definitions of joint manipulation have been proposed. [1] The most rigorous definition, based on available empirical research is that of Evans and Lucas: [2] "Separation (gapping) of opposing articular surfaces of a synovial joint, caused by a force applied perpendicularly to those articular surfaces, that results in cavitation within the synovial fluid of that joint."
Because the process of reduction can briefly be intensely painful, it is commonly done under a short-acting anesthetic, sedative, or nerve block. See also: Intravenous regional anesthesia Once the fragments are reduced, the reduction is maintained by application of casts , traction , or held by plates, screws, or other implants , which may in ...
Manipulation under anesthesia (MUA)—This is performed by a chiropractor certified in this technique in a hospital-outpatient setting when the patient is unresponsive to traditional adjustments. Techniques
[1] [7] One survey of anesthesiologists who practice intravenous regional anesthesia found that 98% used adjuvant benzodiazepines and/or opioids, with benzodiazepines always being given systemically (to the whole body and brain), whereas opioids can be given either systemically or locally (only into the limb being anesthetized). Most providers ...