Femoral nerve palsy

[anatomy]

I am a 49 year old male in very good health.  On 9/27/07 I had a THR.  About 2 weeks later my femoral nerve stopped firing.  About 2 weeks after that I was diagnosed with a pseudoanerysm of the femoral artery.  It was surgically corrected but after 10+ weeks I still have very limited quadricep function (slight contraction of lateralis).  Electrical stimulation in PT gets no response.  The medialis has atrophied significantly.  I cannot support my body weight or extend my knee at all.  Will this nerve respond eventially?

[CCFNeuroMD JT, MD]

Dear anatomy,

Thank you very much for your question. I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

I am sorry to hear that you are suffering from leg weakness following your THR.  As your physician may have already discussed with you, the nerve and the artery travel together through the groin and down the leg, and as such, damage to the artery (i.e. pseudoaneurysm) may cause a secondary injury to the nerve.  Alternatively, the nerves and arteries are in very close proximity to the surgical site and it is not uncommon for some degree of stretch to occur.

Nerve injuries are a bit unpredictable.  Sometime, mild trauma to the nerve, be it from compression or stretch injury, will gradually improve over time.  In general, the most improvement is seen over the course of the first 3-6 months, although mild improvement can happen as much as 12-15 months out from an injury.  
I wish I could give you a definite answer to your question but at this point in time, the best that I can recommend to you is that you participate in physical therapy (obviously, confront your surgeon first to make sure you aren't compromising the hip with the exercises) to maximize the chance of recovery.

You may benefit from seeing a neurologist who may opt to conduct an electromyelogram (EMG) which can detect and localize nerve damage.  In addition, he or she may be able to discuss whether there are any other treatment options available to you.

Thank you for your question, and best of luck.

Sincerely,
JBT, MD

[CC407]

I am 45 year old who is s/p tibial tubercle transfer about 2 years ago on my knee. I have worked in rehab about 2 years now and progress has been very slow. I am finally able to do a straight leg raise and kick my leg about to some degree but do continue to have pain. I continue to walk with a limp. My orthopedic surgeon recommended I see a physiatrist for evaluation. The result of the exam suggested I may have damage to the femoral nerve vs muscle disuse.Im wondering about the tests for examining for the nerve damage-what they would be and if that might be helpful? Are there treatments that help this problem?  From CC407

[Eloisa5]

Hi how you doing?Let me tell you ,About 3 years ago I got a bell's palsy
in my right side of my face,I been dealen with the problem for many years,I been crying to seen my face very bad, now I found out the my friend's wife got one too,She took NEUROBION and she got better 100% ,Do I have to take some Neurobion or Vitamin B12 ?I ask because I wanto to get better please help what to do?

[anatomy]

Thanks for your reply.  I have seen a neurologist and had an EMG and I am seeing a peripheral nerve specialist next week at University of Chicago.  I am just searching to see if there is anything else I can do to increase the likelihood of healing.  I understand nerve healing is unpredicatable and it is a slow process.  I want it to improve now! :-)