Friday, April 12, 2024

Symptoms Of Nerve Damage After Knee Surgery

What Causes Neurapraxia And Whos At Risk

Knee Pain from Peroneal Nerve Irritation Treated with Nerve Release & Regeneration Injection Therapy

Neurapraxia can occur when a nerve has been stretched or compressed beyond its normal range. The damage doesnt actually happen to the nerve itself, but to the surrounding myelin sheath.

Myelin acts as insulation around a nerve and is necessary for the nerve to function properly. Myelin helps electrical signals move quickly along the nerves. Someone who experiences neurapraxia in the nerves of their arm, for example, may find that the arm is numb for a short time. Myelin can often repair itself, allowing the affected nerves to return to normal.

Football players are at an

You may experience neurapraxia after an injury or after an operation that damages some nerves. Its important to know how to respond in both cases.

Research: Doctors Are Looking For The Causes Of Pain After Knee Replacement And It Is Hard To Find

The confusion as to what may be the cause of chronic knee pain after knee replacement is a cause of great concern not only among doctors but obviously among patients. We often find patients to be confused between what is normal and what is not normal after knee replacement.

  • Is some pain normal?
  • Are the clunking sounds normal?
  • Is the instability normal?

Symptoms Of Ulnar Nerve Entrapment

Ulnar nerve entrapment symptoms occur in two main places the elbow and the hand. However, most symptoms occur in hands and fingers. The most common symptoms of Ulnar nerve entrapment are intermittent numbness and tingling occurring in the fingers, especially the ring finger and the little finger. The grip of the affected hand becomes weaker and most patients describe their little and ring fingers as being asleep.

People who type often or play an instrument find it difficult to control their fingers. Any task that requires the use of fingers becomes more difficult. In addition, they become more sensitive to cold temperature and feel pain and tenderness in the inner part of the arm at the level of the elbow. If the condition is left untreated, muscle wasting may occur.

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What Causes Femoral Neuropathy

The femoral nerve is one of the largest nerves in your leg. Its located near the groin and controls the muscles that help straighten your leg and move your hips. It also provides feeling in the lower part of your leg and the front of your thigh. Because of where its located, damage to the femoral nerve is uncommon relative to neuropathies caused by damage to other nerves. When the femoral nerve is damaged, it affects your ability to walk and may cause problems with sensation in your leg and foot. View the femoral nerve on this BodyMap of the femur.

Damage to the femoral nerve can be the result of:

  • a direct injury
  • hemorrhage or bleeding into the space behind the abdomen, which is called the retroperitoneal space
  • a catheter placed into the femoral artery, which is necessary for certain surgical procedures

Diabetes may cause femoral neuropathy. Diabetes can cause widespread nerve damage due to fluctuations in blood sugar and blood pressure. Nerve damage that affects your legs, feet, toes, hands, and arms is known as peripheral neuropathy. There is currently some debate about whether femoral neuropathy is truly a peripheral neuropathy or a form of diabetic amyotrophy.

According to the National Institute of Diabetes and Digestive and Kidney Diseases , diabetes is the most common reason for peripheral neuropathy in people whove had diabetes for at least 25 years.

You might also feel unusual sensations in your legs. They include:

How To Know If Your Knee Pain Comes From Your Spine

Pin on exercise

Many people assume knee pain is always caused by a problem in the knee joints. However, that is not necessarily the case. If youre suffering knee pain or discomfort, there is a possibility that a problem with your spine is the cause.

So how do you know if your knee pain comes from your spine? The muscles around your knees are connected to the nerves in your lower spine so if these nerves are irritated or compressed, your knees may be affected by symptoms such as intermittent back pain, hamstring tightness, weakness in the hips or quads, and the development of bunions on your feet.

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What This Article Tells Us That Is New

  • In a review of more than 12,000 total knee arthroplasty patients during 20 yr, use of peripheral nerve blockade was not associated with peripheral nerve injury. However, patients with peripheral nerve injury were less likely to recover completely if they had received peripheral nerve blockade.

PERIOPERATIVE nerve injury is one of the most debilitating complications of surgery that commonly results in functional impairment, chronic pain, and decreased quality of life.Large retrospective epidemiologic studies have estimated the overall incidence of PNI at 0.030.05%.Although the majority of these injuries resolve over time,it is important for anesthesia providers to recognize risk factors that may predispose patients to PNI. Several procedural and patient-related characteristics have been implicated in PNI.Specifically, orthopedic surgical procedures may place patients at higher risk for PNI,with the incidence of neurologic dysfunction after total knee arthroplasty approaching 10%.

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Nerve Pain After Tkr: An Underestimated Problem

Patients have reported that they have pain for up to three years following surgery. It may be because nerve damage from knee replacement surgery is also possible. Nerve pain is a problem that patients who have had a TKR are not properly diagnosed and treated, which contributes to a low rate of reporting. The duration of peroneal nerve pain after surgery ranges from six to three months, and can be caused by compression or damage. Patients must be aware of their symptoms and seek medical attention if they experience pain that does not go away or worsens. Surgery must be performed carefully and thoroughly before a knee replacement operation in order to reduce the risk of nerve damage.

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How Long Can It Take For Numbness In My Knee Or Leg To Go

As mentioned previously, it is unlikely that sensation will return if the nerve was cut. So, in majority of cases the sensation is unlikely to fully return, although it can happen.

Most people will experience a return in some or part of their sensation. This is probably because the nerve was simply stretched through the surgery. Or other nerves have grown and compensated for the other.

If the nerve is purely stretched, experts would suggest that the nerve should recover in 6-12 weeks.

My advice, is to watch the site of numbness for signs of improvement for the first 3 months. If there is no change in sensation it is likely that the sensory nerve was cut during surgery and any further progress would be minimal.

Some of you may ask if the nerves can simply be repaired since they were cut. Although the concept is sound, the nerve in question is so small that repair would be extremely difficult.

On top of this, there is always a risk of infection which outweighs the benefits of returning the patch of sensation loss.

Thankfully, most people report that it doesnt usually interfere with their quality of life.

Even still, its something that is worth mentioning to patients as one study revealed most patients were either unsure or not told about numbness post-surgery.

Foot And Ankle Neuropathy And Nerve Entrapment

Pain After Knee Replacement: Fixed Patient’s Nerve Pain After Knee Surgery

Nerve entrapment happens when a nerve is under repeated pressure for a long time. Eventually, the covering of the nerve starts to break down and fluid leaks into the nerve, causing swelling and inflammation. Also known as nerve compression or a pinched nerve, nerve entrapment can lead to long-term injury and scarring of the nerve if the pressure is not relieved.

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The Problems Of Obesity

Lets start with a March 2019 study published in The Journal of arthroplasty. Here doctors and researchers examined the existing medical controversies surrounding joint replacement in obese and morbidly obese patients and whether or not a bariatric surgery before joint replacement would help. Over 38,000 patient case histories were reviewed. The researchers of this paper found medical comorbidities and com[plication were higher in the bariatric surgery group than a control morbid obesity group before total joint replacement.

There were short-term benefits in the bariatric surgery. The researchers observed that bariatric surgery prior to total joint replacement was associated with reduced short-term medical complications, length of stay, and operative time. However, bariatric surgery did not reduce the short-term risks for superficial wound infection or venous thromboembolism, and the long-term risks for dislocation, periprosthetic infection, periprosthetic fracture, and revision.

Establishing A Precise Diagnosis Of Where The Pain Is Coming From Can Be Challenging

Researchers at the Department of Surgery, Southern Illinois University School of Medicine offered this assessment in the medical information publication Instructional Course Lectures to guide doctors trying to help patients with pain after knee replacement.

Establishing a precise diagnosis of where the pain is coming from can be challenging.

According to the research: This is what doctors need to look for in trying to find the source of knee pain after knee replacement:

  • Pain after knee replacement can be classified as intra-articular or extra-articular pain .
  • After intra-articular causes , such as knee instability, aseptic loosening , infection, or osteolysis , has been ruled out, extra-articular sources of pain should be considered.
  • Extra-articular sources of pain can be found after a physical examination of the other joints which may reveal sources of localized knee pain, including diseases of the spine, hip, foot, and ankle.
  • MORE: Additional extra-articular pathologies that have the potential to instigate pain after total knee replacement include cardiovascular problems, tendinitis, bursitis, and iliotibial band friction syndrome.
  • Patients with medical comorbidities, such as metabolic bone disease and psychological illness, may also experience prolonged postoperative pain.

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Otc Treatments For Nerve Pain

Over-the-counter painkillers may be the first treatment your doctor recommends. These may include nonsteroidal anti-inflammatory drugs such as ibuprofen or other analgesics, such as acetaminophen or prescription medicines. Other options include painkilling creams, ointments, oils, gels, or sprays that are used on the skin.

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Treating Nerve Pain With The 3 Rs: Release Repair Or Removal

Possible Knee Replacement Surgery Complications

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If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.

Approximately 10% of the general population may experience chronic pain caused by nerve damage. Most of the patients referred to our plastic surgery clinic for nerve pain are seeking relief from peripheral nerve damage, which can affect any nerves outside the central nervous system .

Nearly 90% of patients with peripheral nerve damage can experience the following symptoms in their limbs, hands, or feet:

  • Hypersensitivity

Peripheral nerve damage can be caused by a range of factors outside a patients controlincluding treatments for other health conditions. Many patients struggle with nerve pain after recovering from:

  • Injury:This can include fractures or sprains. Often, we treat brachial plexus injuries, in which an arm is severely stretched or pulled in a vehicle accident, contact collision, or knife or gunshot wound.
  • Disease: Infections, nutritional imbalances, diabetes, and medications such as chemotherapy can temporarily or permanently damage nerves.
  • Surgery: A nerve may be damaged or irritated during majoryet finesurgeries such as a hand or foot fracture repair, joint replacement, or mastectomy.

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Seek Nerve Care Early To Improve Long

Research to better understand peripheral nerve pain is ongoing, and surgical techniques are continually studied and improved to decrease complications such as nerve damage. Nerve pain caused by an injury or operation is not preventable, but it is progressive the longer you wait, the less effective treatment will be. See your doctor right away if you experience symptoms of nerve damage.

If we cant attribute the pain to a nerve, well order more imaging for a closer look at the affected area or refer you to a specialist, such as an orthopedic surgeon, to evaluate for structural causes of pain such as bone and joint issues. Unfortunately, chronic nerve pain rarely goes away completely. However, a combination of multidisciplinary treatments, such as physical therapy, regular exercise, medication, and pain management treatment can hopefully provide significant relief.

I see patients at MedStar Washington Hospital Center and MedStar Georgetown University Hospital. Our team understands the many ways chronic nerve pain impacts quality of life and will work with you and our MedStar Health pain management experts to develop a creative, customized treatment plan that can help you more easily resume your favorite activities.

Why Did I Get Sciatica After My Knee Replacement

You likely have Sciatica after your knee replacement because you arent moving around as much, your circulation is a little limited and you have swelling. Our bodies are made to move, this allows our muscles, nerves, ligaments and tendons to move, too. It allows everything to stretch and glide and not get stuck. Movement also improves your circulation. If youre moving less because you just had surgery then your blood is still circulating, just slower, so it means that different parts of your body arent getting the same amount of new blood to them. New blood to the area brings nutrients to help heal and takes away toxins and inflammation. If you have swelling in any part of your leg it means that those areas have more pressure on them. There is only so much room under your skin for all the muscles, tendons, ligaments, nerves, arteries and veins. So, if swelling is taking up some of that space it just means that there will be more pressure on everything, which also means pressure on the Sciatic nerve. Pressure on the Sciatic nerve then sends the Sciatica symptoms.

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Can Anesthesia Damage Nerves

It is not always possible to fully recover from the procedure within a year or two. *1 nerve damage occurs as a permanent result of an anesthetic procedure. The term refers to surgery involving the cardiac, major vascular, or spinal areas. Most of the time, this is caused by the surgery itself, or it is caused by a lack of blood flow to the spinal cord.

Which Nerve Is Most Commonly Injured After Total Knee Arthroplasty

Nerve Decompression Surgery After Knee Surgery

According to Mayo Clinic research, the standard surgical incision used in total knee arthroplasty almost always severs the infrapatellar saphenous nerve. The knees function is unaffected by the loss of a nerve.

In recent years, there has been debate about the prevalence and predisposing factors associated with peripheral nerve palsy after total knee arthroplasty. Among those who had a documented neurologic complication, 19 TKAs were identified. Other risks to peripheral nerve damage were determined to be non-existent following TKA. After total knee replacement surgery, a complication of peroneal nerve palsy develops. Constipation following a postmeniscectomy tourniquet and functional sequelae. Complications with the peripheral nervous system are linked to total knee replacement. Is postoperative analgesia increased risk of this condition? The orthopedic surgery department at Hospital for Special Surgery is dedicated to treating patients with orthopaedic conditions.

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Nerves And Nerve Injury

Your nerves transmit sensory and motor impulses to and from your brain. Damage to nerves may result in reduction or a complete loss of sensation, weakness and dry skin.

When one of your nerves is cut or damaged, it will try to repair itself. The nerve fibres shrink back and rest for about a month then they begin to grow again. Axons will regenerate about 1mm per day. The extent to which your nerve will recover is variable, and it will always be incomplete. Recovery is improved if the cut nerve ends are brought together and repaired surgically.

If your nerve ends are not brought together, the nerve fibres still attempt to grow and find the other end. However, often the result is a lump of nerve ends that is tender to knocks or pressure and in some cases can be uncomfortable all the time.

Home Care For Knee Pain

Inflammation is the bodys physiologic response to an injury. In treating many types of knee pain, a common goal is to break the inflammatory cycle. The inflammatory cycle starts with an injury. After an injury, substances that cause inflammation invade the knee to assist in healing. However, if the injury and subsequent inflammation is not resolved, inflammation can become a chronic issue, leading to further inflammation and additional injury. This cycle of inflammation leads to continued or progressive knee pain. The cycle can be broken by controlling the substances that cause inflammation, and by limiting further injury to tissue.

Some common home care techniques for knee pain that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation. This regimen is summarized by the memory device PRICE.

PROTECT the knee from further trauma.

  • This can be done with knee padding or splinting.
  • A pad over the kneecap, for example, helps to control the symptoms of some knee injuries by preventing further repetitive injury to the prepatellar bursae.

REST the knee.

  • Rest reduces the repetitive strain placed on the knee by activity.
  • Rest both gives the knee time to heal and helps to prevent further injury.

ICE the knee.

COMPRESS the knee with a knee brace or wrap.

  • Compression reduces swelling.
  • In some knee injuries, compression can be used to keep the patella aligned and to keep joint mechanics intact.

ELEVATE the knee.

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