Femoral Damage After TKR

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