Knee pain can follow any trauma or surgery. If a biomechanical abnormality is noted as a potential cause of the knee pain, different orthopedic treatments are tried. These procedures can range form:
- simple immobilization
- operative fracture and dislocation treatment
- knee arthroscopy
- total knee replacement (TKA).
Despite successful biomechanical treatment by orthopedic specialists, it is estimated that about 3-5% of these patients will have chronic knee pain persisting beyond the expected recovery time. From this point, a number of pain treatments are offered by many specialists. Since the vast majority of these “treatments” focus on treating symptoms, a solution is seldom found. Unlike other specialties, peripheral nerve surgery is focuses on treating the anatomical cause of the chronic pain, ensuring the best possible chance for the cure.
You should see Dr. Ducic for chronic knee pain following surgery, if your symptoms persist:
- After common reasons for prolonged post-operative pain (infection, bleeding, tumor, biomechanical abnormality, and others) have been excluded by your initial surgeon
- Despite the medical care prescribed to you by your surgeon or primary care physician
- Despite supportive care, such as activity and work adjustments, physical therapy
- After six months of prescribed medical and conservative care
Patients with chronic knee pain may report deep knee pain, making it difficult to go up and down the stairs. They may also report superficial skin hypersensitivity often provoked by clothing rubbing on the knee area . The extent of this presentation may vary, depending on the number of nerves involved and the intensity of pain. Failure to intervene in timely manner poses a risk for chronic pain to evolve into more a more complex presentation with involvement of your central and autonomic nervous system – making the pain far more difficult to treat. Therefore, peripheral nerve surgery has an important role in treating chronic knee pain, giving patients a chance to eliminate dependence on pain medications and greatly improve their quality of life. Based on patient presentation and my findings on physical exam, the involved sensory nerves are surgically removed so they cannot continue to generate pain.
During surgery for chronic knee pain:
- You receive anesthesia so you won’t feel any pain during the surgery.
- A small incision is made over involved knee areas to access the damaged and painful nerves. I use a minimally invasive approach, which I described, in order to keep the length of your incision small.
- Involved nerves are removed from scar tissue to eliminate their pain generating function. Since those are sensory nerves, no motor deficits of any kind are expected.
- Skin is closed in anatomical layers
- Ambulation is allowed immediately following surgery, as tolerated, with the aid of crutches.
- Peripheral nerve surgery for knee pain is an outpatient procedure; your dressing will be removed about 5-7 days after surgery, while sutures are removed three weeks later.
If you are not sure about your eligibility for surgery, and if you are not in the Washington, D.C. area, you can send me your records so I can determine if you are a good candidate for treatment. Visit my patient forms page for a downloadable form.