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Author Topic: peroneal nerve being pushed by osteophyte  (Read 2184 times)

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Offline alanbennett

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peroneal nerve being pushed by osteophyte
« on: August 29, 2009, 05:34:58 PM »
Hiu-
After three years of chasing down the source of leg and foot pain and one back operation, I am told that my problem may be in the knee.
 The good news is that the doctors seem to have found a bone growth which is pushing on the peroneal nerve and may be causing the problem.  A nerve block may be scheduled to further confirm that hypothesis.
 The bad news is that the knee orthopedic surgeon says that he is nervous about operating in the popliteal cavity with its mess of nerves and blood vessels. He says that I should go see one of his associates who is a cancer orthopedic specialist who has  operated more often in that challenging area of the knee.
Does anybody have experience with a situation of this type?
Thanks in advance for the help.
Alan

Offline MoLu

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Re: peroneal nerve being pushed by osteophyte
« Reply #1 on: August 30, 2009, 04:30:46 AM »
Hi Alan-

Maybe I can be of some help.  I have had two posterior knee surgeries for tumors in the back of the knee.  They were pressing on my nerves also and have left me with some permanent nerve damage but slight damage.  The tumors did not the surgery.  Yes it is very risky surgery and I can't stress enough that you need an excellent surgeon.  My first surgery was with an OS but my second surgery was with an orthopedic onconolgist like they recommend for you.  I think that is a good idea also.  They make a long S shape cut down the back of the leg.  Maybe about a foot long.  Not so pretty.  I did not have any problems after the surgeries.  It took 6-8 weeks to heal enough to go back to work at a desk job.  It was hard to bend that leg over the edge of a chair especially with the incision resting on it.  I started back slowly working only half days for the first two weeks.  The first op I wore a leg stabilizer for a couple of weeks but the OO just let me use an ace bandage until the stitches came out.  I expected more pain than I had.  It wasn't easy but wasn't so bad.  My TKR was much worse.  The most important consideration is the chance of injury to your nerves and blood vessels.  That is why it is critical to get a well qualified surgeon for this.  Hope this helps.  If you have any more questions just post and I'll try to answer.  Good luck to you.  I know how painful nerve problems can be
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 alanbennett

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Re: peroneal nerve being pushed by osteophyte
« Reply #2 on: September 04, 2009, 09:06:06 PM »
The response(and private communications) from MoLu have been very helpful, but more input on surgeries in the popliteal cavity in back of the knee would be great. In the last week, a pain clinic doctor said that he knew of few operations in that area and an orthopedic sugeon said that he would much rather replace a whole knee! So any further comments, battle stories etc. would be great. Thanks in advance.
Alan

Offline jess8181

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Re: peroneal nerve being pushed by osteophyte
« Reply #3 on: September 05, 2009, 12:51:14 AM »
I also had problem with bone growth in the posterior of the knee due to a car accident. It seemed to be messing with my range of motion. My OS basically said too bad, there was no way he was going in the back of the knee. Too many nerves. All this after he had already reconstrcuted 3 of my ligaments. So I guess it must be pretty rare to due a posterior surgery. That being said, there are a few here who have had it done successfully, it would be extremely important to find someone who has done several of these types of procedures.

good luck
Jess

Offline alanbennett

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Re: peroneal nerve being pushed by osteophyte
« Reply #4 on: November 23, 2009, 02:15:52 PM »
An update:
I've now seen a cancer orthopedic surgeon and a plastic surgeon who specializes in peripheral nerve surgery. They both say no big deal!(well, it's my knee not theirs),70-80% chance of success given the time that the nerve has been compressed and any remaining uncertainty in the origin of the pain, 2-3 weeks of downtime, three hour operation , that they either of them could do the operation, but that the plastic surgeon is probably the better bet given the relatively large number of such procedures that he does. The plastic surgeon said something about wrapping the nerve in some sheaf material which eventually dissappears. At any rate, does anybody have any other relevant experience. Thanks

Offline jess8181

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Re: peroneal nerve being pushed by osteophyte
« Reply #5 on: November 23, 2009, 08:44:51 PM »
I have no advice in this area but I do hope you the best and I'm  very interested in hearing the outcome, since I'm facing the same thing. Although my OS says nothing can be done and never suggested an oncologist or plastic surgeon so this is very interesting.

Offline MoLu

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Re: peroneal nerve being pushed by osteophyte
« Reply #6 on: November 24, 2009, 03:56:19 AM »
Hi Alan-
Just my two cents worth again here.  I wanted to let you know that you are on the right track.  My OO also said that if he had to go in again in the back he'd have a plastic surgeon there to repair the nerve just as your surgeon is suggesting.  I too was surprised when he suggested that and never would have thought of a plastic surgeon doing this kind of repair work.  So sounds like it is standard procedure in these situations.  Good luck and keep us posted.
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 jess8181

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Re: peroneal nerve being pushed by osteophyte
« Reply #7 on: November 24, 2009, 03:59:21 AM »
I'm curious as to why a plastic surgeon? are they farmiliar with the back of the knee???

Offline alanbennett

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Re: peroneal nerve being pushed by osteophyte
« Reply #8 on: November 24, 2009, 02:47:32 PM »
Hi Jess and Martha-
It seems as though we are the only ones on this Board with the issue.It would be interesting to hear from some other people if they have had a similar problem. It's actually fairly rare to be due to a bone growth(there seem to be only a few cases in the medical literature of that type). It is relatively common as the result of an accident.The plastic surgeon looks for, and repairs hopefully, any nerve damage while operating using a microscope.Let me know if you want any more information. I seem to be coming a minor expert on the topic!! There are several medical centers in the country including Harvard, Columbia,and NYU that have focused peripheral nerve surgery efforts.
Alan

Offline jess8181

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Re: peroneal nerve being pushed by osteophyte
« Reply #9 on: November 24, 2009, 11:02:59 PM »
Hi Alan, you are sure right that it is rare! I actually had an appointment with my ever so arrogant OS today and he does not want to touch it. I mentioned the prospect of a nuero surgeon or plastic surgeon for this issue and he stated that it is only orthepedics that deal with these issues. Then I mentioned that there are surgeons that do posterior capsule releases which obviously involves the back of the knee, and he said yes, that he does due them under cirtain circumstanses but not in my case. So now I'm totally lost. I'm thinking od booking an appoinment with an OS that has alot of experience in posterior knee surgery and seeing what he reccomends. I have a few articles about bone being removed in the posterior of the knee. If you want me to send them to you just let me know.