Category

arthoplasty

Mar 29
1

Denervation Surgery Helps Knee Pain After Knee Arthoplasty

By | arthoplasty, chronic pain after surgery, Dr. Tollestrup Blog, knee replacement, Nerve Surgery, Pain after Knee Surgery, success stories | No Comments

Knee Pain After Knee Arthroplasty

Larry had a total knee arthroplasty but after the surgery, he still had constant knee pain. He had decreased range of motion and aching pain in his shin. He couldn’t bear weight or twist without pain in the knee pain.  As a result of the knee pain, he has developed a limp that is causing problems with his hip and low back.

He asked his orthopedic surgeon for help with the knee pain but the surgeon didn’t have an answer for Larry. He believed the pain was just scar tissue and referred Larry to pain management medication.

Second Opinion from Dr. Tollestrup

Larry sought another opinion from Dr. Tollestrup, a peripheral nerve surgeon.

Dr. Tollestrup understands that an orthopedic surgery such as a total knee arthroplasty is rough by nature and can cause nerve damage.

Surgery on the knee joint, whether it is an arthroscopic meniscus repair or a total knee arthroplasty carries with it a small but significant risk of damage to one or more nerves. The trauma to the soft tissue envelope surrounding the knee joint causes swelling, inflammation and scarring that can entrap nerves causing severe pain with motion of the joint.

Patients like Larry who end up in this situation undergo multiple additional orthopedic knee surgeries before finally being consigned to the pain management realm. Once the pain generator is a damaged sensory nerve, it doesn’t matter how many additional orthopedic surgeries the patient has, the pain will not get better and frequently can be made worse.

Dr. Tollestrup examined Larry, listened to history and then ordered a diagnostic block that completely took away Larry’s knee pain. This proved Dr. Tollestrup’s hypothesis that the pain was due to damaged nerves, not some type of residual orthopedic issue.

Disconnecting Damaged Nerves

A detailed understanding of the nerve anatomy around joints provides the option of joint denervation procedure. In this surgery, Dr. Tollestrup locates the damaged nerves, disconnects them and buries them upstream from the area of injury. These nerves can then be handled in specific ways to prevent additional inappropriate stimulation and the formation of painful neuromas. This serves to shut off the pain signal to the patient’s brain and eliminate the sensation of pain in the knee area.

Larry underwent a denervation surgery by Dr. Tollestrup, relieving his chronic knee pain.

A few weeks after surgery, Larry told Dr. Tollestrup his knee pain is 90% gone. He is even playing golf again!

If you or someone you love has knee pain after a knee arthroplasty Dr. Tollestrup can help with peripheral nerve surgery. Fill out the form on this page or call the office at 702-666-0463.

Oct 11
1
Denervation surgery helps patient with chronic knee pain

Knee Replacement Surgery Fails to Heal Pain

By | arthoplasty, Dr. Tollestrup Blog, nerve decompression surgery, success stories | No Comments

Pain Increases After Knee Replacement Surgery

Wanda had a left total knee replacement done by her orthopedic surgeon.

Unfortunately, after surgery, she still suffered from terrible pain. In fact, physical therapy made her pain worse. During physical therapy, she was using a Continuous Passive Motion machine. The more Wanda used the CPM machine, the more she started experiencing numbness and tingling involving the skin over the inside of her lower leg and pain on the inside of her ankle.

In addition, she started having severe, radiating pain starting near the inside of her knee and traveling up her inner thigh into the groin area.

Orthopedic Surgeon Denies Pain

Baffled by the cause of her persistent knee pain, Wanda’s orthopedic doctor just continued to send her to physical therapy. In total, Wanda participated in three rounds of physical therapy. Despite extensive therapy, Wanda’s symptoms never improved.

Wanda’s orthopedic surgeon told her many times that he didn’t understand how she could still be having pain and that everything was perfect with her knee replacement. Eventually, her surgeon started to intimate that the problem was all in Wanda’s head. Unfortunately for patients suffering from peripheral nerve damage, this is not an uncommon experience.

Finding Relief

Luckily for Wanda, her husband researched constantly on the internet and found Dr. Tollestrup. Wanda then came to see Dr. Tollestrup for an evaluation.

After learning about her arthroplasty, Dr. Tollestrup knew that Wanda had most likely undergone an unnecessary surgery because her knee pain before surgery was exactly the same as after the knee replacement. He also suspected that the source of her ongoing pain stems from the small sensory nerves that give sensation to the soft tissue around the knee joint itself.

Based on the description of the location of the new pain and numbness from the groin down to the inside of the ankle that Wanda started to experience after the knee surgery, Dr. Tollestrup also knew that there was a problem with Wanda’s saphenous nerve. A brief physical exam confirmed that the saphenous nerve was being compressed or pinched deep in the inner thigh in a tight space called the adductor canal. Using local anesthetic, Dr. Tollestrup put to sleep the small sensory nerves causing the pain in the area of the left knee. This gave Wanda immediate, temporary relief from her left knee pain, thus confirming Dr. Tollestrup’s diagnosis.

Disconnecting Damaged Nerves

With the accurate diagnosis made, Dr. Tollestrup took Wanda to the operating room.

Through a single incision just above the knee on the inside of the thigh, he was able to find and disconnect all of the damaged nerves to the knee. He also relieved the pressure on the main saphenous nerve in the adductor canal.

Click here to watch this video from the operating room showing exactly what Dr. Tollestrup did in surgery.

By the time Wanda came back to see Dr. Tollestrup for her one-week post-op visit, all of the original pain in the left knee was gone. The sensation on the inside part of the lower leg had returned to normal. She was no longer experiencing the shooting pain up the inside of her left thigh into the groin or the pain on the inside of her ankle.

“I don’t have any pain at all,” Wanda said. “I am so happy I found Dr. Tollestrup.”

If you or someone you know has persistent knee pain before or after a knee arthroplasty, Dr. Tollestrup may be able to help. Please fill out the form on the right or call the office at 702.666.0463.

Sep 27
0

A Tragic Tale of Unnecessary Knee Replacement and Amputation

By | arthoplasty, knee replacement, news and events, Patient Stories, success stories | No Comments

A Tragic Tale of Unnecessary Knee Replacement and Amputation

Kathy’s story is a tragic tale of a misdiagnosis leading to unnecessary knee replacement and amputation. We are sharing her experience in hopes of reaching other patients like her who may be able to avoid the mistakes made by her doctors.

An injury at work left Kathy with chronic knee pain. An orthopedic surgeon suggested a total knee arthroplasty. Kathy agreed.

But after surgery, she continued to have severe pain. Unfortunately, the only solution her surgeon could think of was to replace the prosthetic knee.

This vicious cycle continued and Kathy endured two additional knee arthroplasties. Complications following the third knee arthroplasty left Kathy with no alternative but an above-knee amputation (AKA).

Following the amputation, Kathy developed horrible phantom pain as well as severe residual limb pain in the end of her stump. While the phantom pain was bad, the residual limb pain was more debilitating because it prevented Kathy from being able to wear a prosthetic leg, thus confining her to a wheelchair.

True Source of Pain: Damage to Peripheral Nerves

The real tragedy of Kathy’s story is that it could have almost certainly been prevented had she found Dr. Tollestrup earlier.

In Dr. Tollestrup’s opinion, the most likely cause of Kathy’s original knee pain was damaged peripheral nerves. Sadly, with a knee denervation surgery by Dr. Tollestrup, the knee replacement surgeries and subsequent amputation could have been avoided.

Kathy finally found Dr. Tollestrup. He diagnosed the source of her pain as coming from the multiple neuromas which had formed on the ends of all the nerves that were cut through when the leg was amputated.

Dr. Tollestrup performed two cutting-edge surgical procedures involving a combination of disconnecting the smaller damaged nerves and sewing cadaveric nerve grafts to the larger damaged nerves to prevent re-formation of the painful neuromas. This is a highly complex surgery that Dr. Tollestrup is uniquely qualified to do.

Second Chance: Out of the Wheelchair and Back to Active Life

It has now been about a year and a half since Kathy’s first surgery. Her phantom pain is almost completely gone. The residual limb pain is also drastically improved. It is not completely gone but is down to such a mild level that she is no longer taking pain medication. She is now able to wear her prosthetic leg as much as she wants to without experiencing the horrible pain that she used to. This has freed her from the confines of her wheelchair which has been life-changing for her.

Kathy is looking forward to getting back to a much more active lifestyle again.

If you or someone you know has a peripheral nerve injury or pain of an undiagnosed peripheral nerve origin, Dr. Tollestrup may be able to help. Please fill out a form on the right or call the office at 702-666-0463.