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Patient Information

Manipulation Under Anaesthetic (MUA)

What is Manipulation Under Anaesthetic (MUA)?

A manipulation under anaesthetic is a non-invasive way of restoring range of movement at the knee. Whilst you are under anaesthetic, the surgeons will ‘manipulate’ or move the knee joint through flexion and extension in order to loosen it and reduce pain and stiffness. 

Why do I need an MUA?

Sometimes, the knee joint can become very stiff and sore. This can occasionally happen after knee surgery, most commonly a Total Knee Replacement, where the movements have been difficult to regain. It is thought to be due to scar like tissue forming in the joint capsule causing restrictions. This can mean that you have difficulty with the movement in your knee and can make your days to day activities difficult to perform. 

What should I expect after surgery?


You will aim to be walking around a few hours after your surgery as long as your leg is not numb, the nursing staff can help you to get out of bed. You don’t necessarily need any walking aids but can use them if you did so before your MUA or if you find walking difficult after your surgery.

Pain Relief

A nerve block is sometimes used during surgery which means your limb may feel numb immediately after your operation. It is normal to feel some pain as the block wears off and you will be provided with some painkillers to help with this. It is important to take these as prescribed to keep pain to a minimum.


Ice can be very helpful to reduce pain/swelling. Protect your dressings from getting wet with a plastic bag. Wrap a bag of ice/frozen peas in a damp towel and apply for 10-15 minutes. This can be repeated every 3-4 hours. For knee surgery, elevating your leg on pillows can also help.


It is essential that you begin to move the knee as soon as possible to maintain the amount of movement that the surgeons have achieved. The more that you move your knee in each direction the more likely you are to achieve a good outcome and have less pain overall. You will see a physiotherapist on the ward before you go home who will teach you some exercises that you must continue at home.  You will also be referred to see a physiotherapist as an out-patient at your local hospital after you have been discharged home to continue your rehabilitation and to regularly check your movement. Your consultant will give you guidance on when you can return to work, activities and driving. Your physiotherapist will be able to give you guidance on returning to sporting and leisure activities as your movement and muscle strength improves.

More information

If you have any questions or need any advice about your exercises, then please contact the Physiotherapy Department between 8am - 4pm Monday to Friday on 0121 728 9442.

The Royal Orthopaedic Hospital | T: 0121 685 4000 |