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Author Topic: nerve entrapment around popliteal fossa - surgery suggested - help needed  (Read 3280 times)

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Offline kateplate

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Having had troubles with cartilage problems that have resulted in 3 arthroscopies in 24 months, I  then developed peripheral neuralgia in my peroneal and tibial nerves that has now been isolated as being a direct consequence of my latest left knee injury in May '07. I have just had EEG / EMG studies that were all normal, and the consultant feels that I need further investigation via knee angiogram / arthroscopy / open knee surgery. The aim is to deal with the symptoms, reduce the heavy duty pharmacological intervention for pain relief, and get me back to normal, as far as possible.

I need to know what happens if I am subjected to open knee surgery to release the nerve compression, and how this might have an effect on my immediate mobility and pain levels. I assume that if I have to go for surgery I will need to stop the lyrica and buprenorphine beforehand. I have also been led to believe that I MIGHT be on crutches for several weeks, so how long would I need to stop driving for, after open surgery around the popliteal fossa?

I am also searching for other people that have had surgery around their popliteal fossa to release nerve compression. It seems to be a fairly rare condition and I would like more support, if possible.

K
Dec '05 RK plm; Dec '06 RK plm&pmm; Sept '07 LK pmm. Jan '09 LK pmm and synovial joint repair / removal of fat pad.
March '09 insertion of spinal cord stimulator for permanent nerve damage in L leg.

Offline MoLu

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Re: nerve entrapment around popliteal fossa - surgery suggested - help needed
« Reply #1 on: December 22, 2007, 04:25:40 AM »
Hi Kateplate-
Hopefully I may be able to answer a few of your questions.  I have had two open posterior synovectomies and tumor removals.  I too have some tibial nerve damage due to compression from the tumors.  My EMG also came back normal.  I just don't understand how that can be but there it is.  I have a numb heel, two toes , fat pad under toes and sometimes up the back of my calf.  For the most part it is not painful just numb.  I'm on Lyrica also but that came later as my back has started to act up now too.  My last surgery took 6 hours but as you know they will be operating in a very delicate area.  My last surgeon actually said if he has to go back in for more tumor removal he would be taking a plastic surgeon.  Thought that was interesting.  He would have him do the repair work to the nerve if necessary.  Luckily so far it hasn't happened yet.  I was having a lot of cramping in toes and calf muscles also but Lyrica has really helped.  Do you have problems with cramping?

I was probably on crutches for 3-4 weeks following surgery.  I didn't drive for the first two weeks at least.  I probably could have but doctors don't release you while you are still recovering from the anesthia and pain meds.  I stopped taking narcotics the minute I got home.  I don't tolerate them well and just switched to Ibprofen.  Was able to manage ok with that.

What is causing your nerve compression if I might ask?  You said it was from an injury?

Make sure you have a good doctor and feel confident in his ability for this procedure.  It's a very delicate area and you want only the best when working in this area.  Good luck to you.  If I can help in anyway let me know.
Martha
Synovial Chondromatosis
9/16/05 Frontal synovectomy and tumor removal
10/26/05 Posterior open knee surgery and synovectomy with tumor removal
3/8/06 Disease is back
4/26/06 Frontal arthoscopic synovectomy and posterior open knee synovectomy
6/23/06 Disease is back
7/24/07 Synvisc
10/23/08 TKR

Offline kateplate

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Re: nerve entrapment around popliteal fossa - surgery suggested - help needed
« Reply #2 on: December 24, 2007, 02:35:39 PM »
Hi Martha,

Thanks for your reply. I had a feeling that the suggested surgery might be quite complex, and your reply also suggests this. I just need to talk to the OS now. I am lucky in that I have been referred to one of the major orthopaedic centres in the UK, so good care pretty much guaranteed!

My history is very simple. I suffered a minor cartilage tear in my L medial knee cartilage in May '07 as a result of standing up! I also suffered a similar injury in the R knee in Oct '05 that led to 2 arthroscopies. The L knee injury was v minor and the meniscectomy straightforward, but the nerve compression / irritation has gotten worse and worse since approx June '07. I now suffer from awful allodynia on the lateral part of my leg (can't bear ANYTHING touching it and get awful feelings of icy water etc drippng down my leg), and I also feel pain, electric shocks and heat in my outer leg, sole of my foot and 3 biggest toes. The pain really keeps me awake every night and it's only recently that the pain managment clinic have given me adequate pain relief in the form of buprenorphine patches and lyrica. I don't really get much in the way of cramping, but sometimes it happens. Cramp is an awful pain so hope you manage to get yours under control.

I don't think I am looking at tumour removal as nothing has been found, but scar tissue could be an issue. 6 hrs sounds a hell of a long time for an op!! Like you, I am desperate to drop the narcotics as they make me feel very odd and I'm currently trying to raise 3 children and work p/t. It's tough trying to strike a balance at present.

Martha - thanks for your info, and hope you are OK at present. If you know any more about scar tissue around nerves, or can give me some insight into size of scar and physio expectations then that would be great.

A big thankyou - Kate

Dec '05 RK plm; Dec '06 RK plm&pmm; Sept '07 LK pmm. Jan '09 LK pmm and synovial joint repair / removal of fat pad.
March '09 insertion of spinal cord stimulator for permanent nerve damage in L leg.

Offline MoLu

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Re: nerve entrapment around popliteal fossa - surgery suggested - help needed
« Reply #3 on: December 25, 2007, 04:59:02 PM »
Hi Kate-
It has been interesting reflecting back on my past two surgeries.  Two different doctors doing the same procedure but each did it differently.  Outcomes the same.  Both dr's cut the leg open the same way using a "S" cut measuring about 11 inches.  It's most definately a big old scar.  First OS used stitches when closing and the scar healed up nicely.  Second surgery the OO used staples and cut in exactly the same line.  The wound healed well both times but the scar is more visable.  I don't know if it is because of having it done twice or if it is the difference using staples vs stiches.  Something to ask your dr if you are concerned about the looks of the scar.

The first operation the OS had me use a leg immobilizer for the first week.  He wanted another week but I begged him not to.  It was horrible.  I started PT after two weeks.  Going twice a week for several months.  I did fine but the disease came back after just a few months and I was back talking surgery again.

Second operation I was in the hospital for 3 days with a immobilizer but only had it on in the hospital.  Didn't have to wear it when I went home.  Started PT right away and went 2-3 times a week for 4 months.  Was able to bear weight with crutches right away.  Never had an issue with scar tissue.  I massaged my scars at home right away and that always seem to help me.

Unfortunately for me my disease keeps coming back.  At least it seems to have slowed down but now I'm looking at a TKR.  My knee still doesn't feel good.  Swollen everyday from the moment I get up and my kneecap bothers me the most.  OA has set in so a TKR will have to happen at some point.  Trying to delay as long as possible.  The thought of another operation just makes me cringe.  I sure you feel the same way.  I'm actually home right now recovering from a hysterectomy.  When it rains it pours.  I am scheduled for another MRI Jan 3rd to see if my discomfort is from the OA or the disease.  At this point I can't tell the difference.  Only an MRI will be able to tell me that.  Looking forward to see what it says.  It would be wonderful to find that the disease has stopped and it really is only OA bothering me.

I find that mentally getting back to normal has been my biggest problem.  After so many surgeries I bet it has taken me over a year to feel more like myself.  I'm 57 so my kids are grown and I have a very kind and patient husband that has made it easier for me to recover.  You have your hands full to be sure.  Maybe that in a way helps you get back on your feet faster just because you have to.  It's not easy though and I can feel for you.  I do work full time outside of the home and it has not been easy for my co-workers to cover for me during my absences.  But what can I do.

I do hope you have a very successful surgery and a quick recovery.
Martha
Synovial Chondromatosis
9/16/05 Frontal synovectomy and tumor removal
10/26/05 Posterior open knee surgery and synovectomy with tumor removal
3/8/06 Disease is back
4/26/06 Frontal arthoscopic synovectomy and posterior open knee synovectomy
6/23/06 Disease is back
7/24/07 Synvisc
10/23/08 TKR

Offline kateplate

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Re: nerve entrapment around popliteal fossa - surgery suggested - help needed
« Reply #4 on: December 27, 2007, 10:08:42 AM »
Thanks  Martha - that all really helps.

I seem to have been on and off crutches, having ongoing physio, and juggling life best as I can since Oct 2005. I certainly think my age (39yrs), children (2, 4 and 14) and work, have helped to keep me motivated. I also have a kind and patient husband and neither of us is worried about scar issues etc - we just want things sorted

I'm really hoping that once this is isolated and dealt with my worries will be over - the thought of having your condition and waiting for the next thing to crop up would be soul destroying. Don't rule out TKR. My mother had hers last Feb for OA and recovered amazingly well. She's now back to a normal life. Her op was done under epidural so no worries about recovering from anasethetics. She only stayed in for 3 days and was back on her feet without crutches / stick within approx 2 weeks.Think on..

Take care, K
Dec '05 RK plm; Dec '06 RK plm&pmm; Sept '07 LK pmm. Jan '09 LK pmm and synovial joint repair / removal of fat pad.
March '09 insertion of spinal cord stimulator for permanent nerve damage in L leg.















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