Scar Tissue Causing Nerve Entrapment and Compression
Scar tissue can be an insidious fiend.
I've been dealing with scar tissue/arthrofibrosis for 7 yrs. I've had it grow on just about every structure, in my knee. Among the many structures, scar tissue made it's way, to one of my nerves. The Infrapatellar Branch of the Saphenous nerve. This nerve is located anteromedially, very close to the MCL.
My anteromedial knee pain started right after my TKR. Pain was located in the MCL area and it was very tender to touch. My hometown OS explained to me that when a TKR is done, the MCL is elevated out of the way, from all the work being done in the knee. Sometimes a patient will suffer a mild MCL sprain as a result of this elevation. During my rehab period for the TKR, exercises were adjusted so as not to cause further irritation to this area. I was told it would take several months for an MCL to heal.
It took 4 months for the pain to finally subside. During the next 6 months, I would have periods where this area would "flare" up. It would become swollen and was very tender to touch. I attributed it to over doing activity. This was happening during a period I was trying to get back to riding my mountain bike and figured I had done to many hills. I would usually cut back activity, ice down and take some anti- inflammatories.
This treatment seemed to suffice, til I was about 9-10 mos post-op, from the TKR. This time period is where the knee flared up again. Only this time, the pain was worse, it was constant and very tender to touch. The increased pain made it difficult to do a quad contraction, during my rehab exercises. I tried all my previous treatment methods, ice, decreased activity level, and took anti-inflammatories. This time, nothing was working. I just tried to ride it out, thinking time, would eventually make it go away.
November passed , December passed, now it was January of 2006. It was time for a scheduled surgery I was having for lateral/posterolateral scar tissue removal and removal of a fabella bone. During my pre-op appoinment, I told Dr Noyes of this medial sided pain I was haivng. I said it had started after TKR surgery, lasted 4 mos, went away ,but would flare up occassionally. I told him how at 9-10 mos post op, the pain came back and was more intense and constant, along with being very tender to touch. He examined the area in question. He came to one particular spot to palpate. That is when I hit the ceiling, with pain. The pain was incredible. He said that was classic for nerve entrapment pain. I probably had an entrapped , compressed nerve from scar tissue. I now had another added procedure to the surgery.
The Doctor performed a very painstaking debridement, decompression and excision of this nerve. This is known as a neurolysis and neurectomy. I was told my MCL and medial side were incased in scar tisssue.
This surgical procedure stopped a very painful nerve problem. Hopefully I will not have scar tissue return to that area.