This is partly a theoretical question. Could neurological damage occur during total knee replacement surgery on a patient with undiagnosed popliteal artery occlusion (distal clot within the popliteal artery) with sclerotic changes within the superficial femoral artery? Patient had complained of chronic light pain/very mild numbness/funny feeling in lower outside and front of leg down across outside of ankle/across top of foot and into instep with some cramping and aching in lower leg on the front prior to surgery. Later vascular examinations showed popliteal artery occlusion with ankle brachial index at the level of posterior tibial artery 0.67 indicating moderate occulsive disease and at the level of dorsalis pedis artery 0.43 indicating severe occulsive disease. Surgery done with tourniquet procedure of 39 minutes.
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. Peripheral nerve damage after knee replacement surgery is certainly possible, but the exact conditions that predispose to this injury are not well understood. The nerves involved are generally the peroneal/deep peroneal and more rarely the femoral, sciatic and saphenous nerves. The method of injury is not always clear. It appears that this damage is likely due to direct compression/ischemia by the tourniquet (but injuries have been reported in times <75 minutes with carefully monitored pressures) and some surgeries employ tourniquet times of 2-3 hours (probably the limit) without injury. Peripheral vascular disease, previous back injury/surgery and peripheral neuropathy may predispose to injury. The use of epidural anesthesia and awkward positioning during surgery have also been implicated in nerve damage.
I would recommend that you get an EMG/nerve conduction study to evaluate for signs of nerve/muscle damage. You should also see a vascular surgeon for consultation on your peripheral vascular disease. Neuropathic pain medications such as Neurontin, Lyrica, Elavil, Pamelor, Maprotiline, Cymbalta, etc. are generally most helpful for pain associated with this type of damage.
I hope this has been helpful.
Copyright 1994-2017MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.