MUAs can lead to adverse outcomes, including fractures, rupture of tendons, damage to the prosthesis, heterotrophic ossification, muscle tears and bleeding and the return of scar tissue. For these reasons treatment patterns vary widely. MUA after TKA is more likely to be to be successful if performed in the first 8–12 weeks after surgery. After 12 weeks manipulation is much less likely to have an acceptable outcome. If the fibrosis is chronic (more than 12 weeks) there is a decreased likelihood of success with MUA, and open lysis of adhesions is sometime performed. However, this carries with it the attendant risks of another open procedure (i.e., infection, blood clots, blood loss, etc.) and the return of scar tissue. References
External links
https://arthrofibrosis.info
http://kneearthrofibrosis.com
http://www.kneeguru.co.uk/KNEEnotes/primers/complications-rehabilitation/key-arthrofibrosis-resources-kneeguru-site
Rarely, severe allergic reactions may occur, including a rash or swelling of the lips or gums, which may require urgent medical assistance. Mild dry mouth or chapped lips may also occur when taking this medication. Drinking a glass of water is recommended with each dose of guaifenesin. Pharmacology
Mechanism of action
Guaifenesin is thought to act as an expectorant by increasing the volume and reducing the viscosity of secretions in the trachea and bronchi. It may aid in the flow of respiratory tract secretions, allowing ciliary movement to carry the loosened secretions upward toward the pharynx. Thus, it may increase the efficiency of the cough reflex and facilitate removal of the secretions. Guaifenesin has muscle relaxant and anticonvulsant properties and may act as an NMDA receptor antagonist. History
Similar medicines derived from the guaiac tree were in use as a generic remedy by American indigenous peoples when explorers reached North America in the 16th century. The Spanish encountered guaiacum wood "when they conquered Santo Domingo; it was soon brought back to Europe, where it acquired an immense reputation in the sixteenth century as a cure for syphilis and certain other diseases..."The 1955 edition of the Textbook of Pharmacognosy states: "Guaiacum has a local stimulant action which is sometimes useful in sore throat. The resin is used in chronic gout and rheumatism, whilst the wood is an ingredient in the compound concentrated solution of sarsaparilla, which was formerly much used as an alternative in syphilis.