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Author Topic: Saphenous Neuroma  (Read 22991 times)

Offline raul

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Re: Saphenous Neuroma
« Reply #15 on: April 16, 2012, 11:09:11 PM »
i am replying here hoping i will get some valuable information. i come from Romania, a country in Europe of wich i am sure most of you haven't even heard and we haven't got such good orthopaedic surgeons here. in february 2010 i have had an ACL reconstruction in my right knee, with semitendinosus and gracilis grafts, from the same leg. i was not allowed to bear weight on that leg for 5 weeks ( the poor prepared surgeons i was mentioning ) but i was doing passive flexions-extenioms in this interval. and plus, i was told not to do any tipe of quadriceps contraction during that period. after those five weeks i was told to to as a rehab knee extensions with up to 5 kg. i regained my flexion quite easily, reaching 180 degrees of flexion in about 3-4 months. my problem was my extension. i couldn't straighten the leg, i was at about 10 degrees with the leg bent. and the problem was that when i was trying to bend my knee, i felt a terrible pain under my knee, in the medial side, right where the incision hor harvesting the graft was made. i mannged to get normal extension in that right knee after about one year. but every leg extension causes a very big amount of pain in that area and it is like something is simply holding my knee back, not letting me to straighten it. the thing is that if i have someone manipulating my leg and get it from flexion to full extension, the pain doesn't appear at all. as soon as i involve my qud muscle, the pain from under my knee, on the medial side simply blocks me from doing natural movements. can i be what you are experiencing, my friends? i mean a saphenous nerve neuroma ?  mtlady, you said you would gladly answer our quoestions.. please, i need someone who has passed trough all these and could give me some advice! thank you all and sorry for the long post and probably my bad english!
   

Offline mtlady

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Re: Saphenous Neuroma
« Reply #16 on: April 18, 2012, 10:08:14 PM »
Hi Raul,

Your problem has some similarities to my saphenous nerve problem.  I also have extreme pain if I try to use my quadriceps muscles, so I am not able to straighten my legs unless it is passively.  This makes standing or walking very difficult for me, so I spend most of my time in a wheelchair.  If I do stand up I have to leave my legs bent.  If I take strong pain medication, I am able to straighten my legs a little easier.  From what I have read, this is typical for a person that has saphenous nerve entrapment.  The saphenous nerve can become entrapped if the normal connective tissue between thigh muscles starts to constrict or "choke" the nerve, causing pain.  Scar tissue from surgeries or injuries, an inflamed knee bursa, or a mass (tumor, cyst, etc) can also entrap the nerves.  I have even read that varicose veins can put pressure on these nerves if they are in close proximity.  Some people with saphenous nerve pain do not necessarily have entrapment, but their nerves have been damaged during knee surgery. 
Neuromas form when nerves have been cut.  The cut nerve tries to regenerate, but is unable to in a normal fashion, so it forms a mass of disorganized neuronal tissue at the cut end.  I know several people that have formed neuromas after having knee or leg surgery because the surgeon cut a nerve either accidentally or could not avoid cutting it.  Their orthopaedic surgeons removed the neuromas for them.  One of my friends has them removed every 8 years or so.  You may even be able to feel the mass under your skin - it's like a "pea" or "marble" -sized growth. 
In my opinion, it is possible that you have a saphenous nerve problem.  The pain is typically on the medial side of the knee, but it can radiate across the front of the knee, down the medial side of the calf to the ankle, or even up into the mid-thigh.  A good way to diagnose saphenous nerve pain is to have a doctor inject anesthesia near the nerve and see if it relieves your pain.  This is a "nerve block."  I have had two nerve blocks performed and it has relieved my pain temporarily.  An anesthesiologist, physiatrist, or other physician trained in these types of injections can do this.  Sometimes these injections can provide long-lasting relief.
I have not had any significant improvement with injections, pain medications, etc. so now I am hoping to get an appointment with a peripheral nerve surgeon.  I am considering going to Johns Hopkins in Baltimore or Massachusetts General Hospital in Boston.  I hope to have surgery to either relieve any entrapment or just completely remove the saphenous nerves.  Complete removal of the nerves would cause some numbness in the knee and lower leg, but will not affect muscle function, since they are only sensory nerves.  I have also corresponded to another user on this site that had surgery in the UK.
It took me months and several doctors to finally get a diagnosis.  Many doctors have never heard of saphenous nerve problems (saphenous nerve entrapment, saphenous neuritis, paresthetica gonalgia).  While I think that it is a possible diagnosis for you, it is only my opinion, and I am not a doctor.  Do you think you could ask your doctor about this?  I had to actually bring some articles about saphenous nerve problems to my doctor because he had never heard of them.

Hope this helps!

mtlady 
   

Offline cattech1

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Re: Saphenous Neuroma
« Reply #17 on: March 13, 2014, 07:08:43 AM »
For the past 11 mos. since bilateral knee replacements, I have been in pain daily taking norco to tolerate the burning , tingling, jab by, hypersensitivity in both knees. I also have severe tendonitis behind both knees that started a week into rehab? This has been a real life changer- had to cut back to part time at work losing benefits, inability to function very well, lots of depression and crying, not going out once the pain starts for the day. My ortho surgeon told me at 3 mos. post op to take Tylenol and get off the codeine as if that would handle the pain!?  He recommended I see a pain specialist, so after 2 pain specialists, another ortho surgeon, and 8 acupuncture treatments, I finally was referred to an amazing orthopedic surgeon who only does revisions and sees all of the botched surgeries.  Within 15 minutes of examining me, he knew what was causing all of my pain. 1) neuroma to the infrapatellar branch of the sapheinous nerve, two geniculate nerves set off and my ligaments in the knee had loosened after surgery allowing the top half and bottom half of my legs to slide side to side causing the tendonitis. His treatment plan for me was a referral to a plastic surgeon who last week dissected the neuroma and buried it in muscle and removed the geniculate nerves and buried the ends in muscle. A week post op and I am already flying high with no pain or any meds!! Can't keep the smile off my face! :) The fix for the tendonitis isn't so easy. Once the incisions heal, I'll be on anti-inflammatories to see if we can calm down the tendons. Otherwise, wait until the implants get loose from all of the side to side movement, instability of joints and then replace the implants with a hinged knee implant. 

Offline mtlady

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Re: Saphenous Neuroma
« Reply #18 on: June 27, 2014, 05:37:06 AM »
Hi cattech1,

I just read your post and I congratulate you on finally getting relief from the painful neuromas in your legs!  It makes all the difference when you find a doctor that is knowledgeable (and willing) enough to figure out what is causing your pain.  I saw so many doctors that didn't give me the time of day, but eventually, with the help of someone on this site, I was also able to find a surgeon to help me with the pain caused by my saphenous nerves.  I am wondering if we actually saw the same surgeon, because I also was operated on by a plastic surgeon that also is trained in peripheral nerve problems.  Anyways, I just wanted to see how you were doing and also ask if you are in the US?  I assume you are, but another person on this site, who is in Europe, is looking for a surgeon to help with their saphenous nerve problem.  Just wondering if your surgeon might be more accessible to them....

Thanks!

mtlady

Offline infrapatellar saphenous

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Re: Saphenous Neuroma
« Reply #19 on: October 19, 2016, 12:05:15 AM »
dear cattech1 and mtlady,

I am so happy to hear you found people who recognized and dealt with the issue. I believe I have the same issue - burning pain in area below and medial to patella after a fall 7 months ago. I feel it when I stand up. This issue is baffling to 99% of doctors apparently - pain management docs do not even seem aware that this nerve exists...

can you give me the names of the plastic surgeons you saw to remove your saphenous neuroma?

Thank you for giving me hope!

Best,

Saphenous Neuroma

Offline Automatik

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Re: Saphenous Neuroma
« Reply #20 on: November 13, 2016, 02:15:59 AM »
Wow, I feel so lucky to have stumbled across this thread. Thanks so much for sharing. I have been having bad anterior medial knee pain for a long time since initial soccer injury and it "flares" up when I hurt my knee. MRI is negative for meniscus and ligament tears.  Hopefully this is it because OS don't seem to know what's wrong with me, and will not do surgery. Even though my 2nd opinion OS won't be able to do much for me, I will definitely bring this condition to his attention.

A life with knee and leg numbness but still having muscle function sounds great compared to being in pain and not being able to use muscles properly, leading to imbalance, and more knee injuries. This surgery also seems like it would be a "walk in the park" compared to knee athroscopy, which could make this condition must worse if I do have it. Worth getting checked out for sure!

How do I know I have this, is the pain level constant, or is more pain felt with certain activities? Has anyone had this surgery done? If so, hows the pain now, is it gone? What's it like compared to before? Are you glad you had the surgery? Thanks so much in advanced for any insight or opinions!
« Last Edit: November 13, 2016, 02:41:15 AM by Automatik »

 

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