Femoral Damage After TKR
Posted , 11 users are following.
I posted a discussion "It's going to be one of those nights" and this discussion was prompted by questions about my diagnosis of Femoral Nerve Damage/Palsy at 7 weeks post op (or 6th week) TKR.
From my perspective, if you need the proper terms and medical explanation Chico is your guy!😬
Surgery on December 16, 2016 went great! Previous ACL surgery about 35 years ago after field hockey injury. TKR for OA. Severe birth deformity of the patella discovered during surgery.
Once the nerve blocks wore off severe pain. Still normal. Worrying at that point - couldn't lift my leg for all the $$$ in the world - the straight leg raise.
Got home after 3 day hospital stay. Abnormal - my toes would hardly move if I tried to wiggle them. Home therapist told me to sit on side of bed and "walk" my toes forward. Almost impossible. My foot was like a dead fish. OS said come in. Sounds like "drop foot". After examination still vague, did not diagnose it as drop foot but says "it looked like it".
Had all the other symptoms of TKR recovery. Except severe pain continued, not just my knee but my leg. Entire leg and foot. Poor rehabilitation even though I started physical therapy on Day 1 after surgery. Most significant symptoms - inability to do a straight leg raise and severe, ongoing pain in leg not just knee.
Physical therapist called OS re: poor rehabilitation etc. OS did EMG (painful/Needles) and a nerve conduction test. Results showed femoral damage, nerve damage and excessive weakness of the quads beyond "normal" damage that occurs as a result of the surgery.
Femoral damage causes severe pain, areas of numbness, sensations all over the leg and restricts movement, weakness and instability. Pain is in entire leg (I get a lot of pain where the nerve block was done), my ankle and foot hurts too. Ultimately it is a toss up between the nerve block and tourniquet that causes this damage.
Prognosis - Ongoing severe pain over the leg, poor rehabilitation (especially with weakness of the leg and rehabilitation of the quads.), immobility. Electrical stimulation twice a week, physical therapy 2 a week.
Ultimately time is the main factor in this healing. It is a rare complication but not that rare. Used to be a heavy smoker as well and cannot help to wonder if this was a contributor.
So I feel like everyone else going through a rough recovery but with added ongoing strong pain over the entire leg and foot. My progress is at a snails pace but at least I am making progress!!!
I never feel like I am worse off than all you guys except that I am going at a really slow crawl with recovery and that I just have a different pain level at times. YET I have seen so many TKR patients still suffering from severe (and worse yet- relentless) pain without any complications.
In hindsight - if you cannot or barely do a straight leg raise; severe ongoing pain and pain and weakness in foot - see someone!!!
3 likes, 37 replies
chris00938 Milla2017
Posted
Milla, my heart goes out to you! Thank you so much for telling us all that - it helps us put the bits and pieces together to understand what's happened to you! I'm so pleased that you ARE making progress, even though it's slow. The fact that it's going in the right direction is so good! Thinking of you!
Milla2017 chris00938
Posted
jan01779 Milla2017
Posted
Hi Milla,
Thanks for your explanation now I get it. Very clearly put.
I hope the pain clinic sorts the pain out and hope your recovery albeit slow is good. You sound very determined and still young so it might be slow but sure.These days there is no.need to have uncontrolled pain.
I guess if you are not satisfied you'll get a second opinion.
I have had a relatively smooth recovery at 17vweeks but RA inflammation got in the way some days 😯.
Certainly reading Oldatguys and Chicos posts have helped. Admiration for the philosophy there so true you have to stay strong.
All the best Lee.us all posted, Jan.
liz54071 Milla2017
Posted
Hi Mila, I understand your situation. I do not get ain daily but pain occurs when I try to lift my leg for my extension exercises It feels like there is a badn below the knee, not sure if tit's the implant but it feels like something is sitting there preventing it from lifting further. I then will nootice swelling in my feet along with numbness especially to my toes1-3. I will restart PT and thinking of a second opionion..hang in there
cynthia89958 Milla2017
Posted
Hi Milla,
?I've had a number of these symptoms although toes are OK, ankle feels as if broken at times. Not to say I have anything as bad as your diagnosis but certainly more severe neuro pain all over leg than I'd expected and leg does not lift etc.
?3 weeks now since surgery. Getting checked out as progress has been slower than expected. I do hope you will continue to make a good recovery, even if it is gradual. Just not having the severe pains at night would be wonderful for me now.
Milla2017 cynthia89958
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liz54071 Milla2017
Posted
Hi Mila, My test showed neuropathy. Certainly t will take a long time to heal.Keep on with your exxercises and Let's keep the faith!!
Milla2017 liz54071
Posted
martinarvelo Milla2017
Posted
Well probably my case is not as bad as yours, but lots of similarities. . however, I've never received any sort of definition. after the op, couldnt put my foot to floor or move the foot at the ankle . .it just sort of hung there. the specialist even came in to see me on a sunday, driving some seventy miles from his place of residence. He told me later he was afraid that the nerve had been severed . . they kept on at me to walk, but it was impossible . .while I could lift the leg, the foot just dragged . .rather like your wet fish! . . .Pain in the thigh area was excruciating . like someone ripping the flesh off with a hot knife. . after a couple of days, tingling and burning in the foot, like a very strong pins and needles. . . . i couldn't do the straight leg lift for about fifteen days. A month or so later I was diagnosed with polyneuritis, but I honestly think it was a side effect of the operation, although they hum and haw and say probably not . . strange though how it all started the day after the operation! Two years post op, the thigh is still numb, and yet painful to press . .the foot still tingles and burns especially at night . . but I have movement and a good knee, so all in all I am quite happy! I realise that it could have been a lot worse!
chris00938 martinarvelo
Posted
That sounds dreadful Marinavelo! NO idea this sort of thing could happen! Waiting for the other knee to be done and hoping it's all straighforward - it's alarming what CAN happen! I'm glad you've got movement but sorry about the lingering problems, that's for sure!!!!!
Milla2017 martinarvelo
Posted
Wrote you practically a manuscript ... Lost the Wifi signal and it's gone! 3 am stil up will try again tomorrow
martinarvelo Milla2017
Posted
I hate it when that happens! My computer sometimes just stops working, and I lose whatever I am sorking on . .Probably time for a new one, but I hate to part with over a thousand euros. . .Macs are very expensive over here (well, everywhere now) . . but I can't face going back to a PC and relearning everything! Hope you got some sleep ater 3 am! I remember those jights so well . . since I've been taking Lyrica I sleep better than I have for the last fifty years!
Milla2017 martinarvelo
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I don't know but as far as you described it I don't see how you were NOT diagnosed with femoral damage. I think the only differences probably how severe quad palsy was in your case. Took me 3 months to lift that foot and leg a hair. After all it is relative. It is bad for everyone in their own way. No one suggested the nerve tests? But the important thing is you have moved forward. You say you have movement and mobility. Normal or how close to normal? Boy as if the "regular" recovery from this isn't brutal enough! But we shall prevail!🌟🌟🌟
martinarvelo Milla2017
Posted
Well, I saw the specialist after the op . . and then at the six weeks mark . .and that was it. . Not much after sales attention here in tenerife! I did have nerve tests, but that was for the meralgia parestetica (agony!) and the neurologist insisted it had nothing to do with the operation (absolute rubbish!) Obviously my nerve was not as affected as yours, because around the fifteen day mark I actually managed to walk a few steps, and lift my leg from the bed. . .Movement of the operated leg is normal now . .there is still a strange tight band feeling above the knee, and I think that will never go. It's the same as a tight band feeling I had around the waist when I had an illness which damaged my sciatic nerve Guillain Barre) , so I think it's a clear sign of nerve damage. (thought I had multiple sclerosis for a while!)I can walk well . . climb stairs, but going down is still a problem, not because of my knee, but because of the ankles which very painful . . falling to bits here! I think I'm pretty lucky in all . . .although the first months the pain was pretty bad, from the top of the leg to the bottom, in the end I am virtually pain free . . so hang in there, and hopefully things will eventually improve for you. As you say, it is a brutal operation! I wish you well . . .
Milla2017 martinarvelo
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Good to hear you are doing good now. But I agree with you about it being rubbish. My OS is super defensive about my diagnosis. I think he is a good surgeon but that is all he wants to do. He doesn't "care" for the aftercare.
I am now in the pain clinic - got 4 new prescriptions and in another 2 weeks we will determine if I need more testing. Right now we are treating my ulcerated esophagus and stomach with Protonix and liquid Lidocaine (for pain with swallowing) and Friday I start new anti inflammatory Meloxicam. Told me to stay the heck away from Ibuprofen and Naproxen. Things can only go up 🔝 from here!
marilyn10235 Milla2017
Posted
Glad you are getting things sorted now Milla. Let's hope it all does the trick.
I wish you well.
Marilyn
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