Surgical Treatment of Painful Nerve Injury after Knee Arthroscopy.

Abstract

Background; Pain at the surgical site is an important concern, especially in locations of main joints which may resolve important limitations of movement. Materials and Methods; We present the case of painful dysesthesia after knee surgery for traumatic meniscal rupture in a young lady. She presented with painful dysesthesia, limitation of knee flexion, and severe pain in light touch and pressure on the mid-patellar area of the left knee.  Tinel’s sign at the site of surgical scar, dysesthetic area (abnormal sensation) corresponded with the medial reticular nerve at surgical exploration under a microscope. Results; Microsurgical exploration of the three nerves of medial subcutaneous nerves revealed the branch stack in the scar. The distal end was internalized subfascial inside the muscle fibers of the medial vastus of quadriceps femoris muscle according to Dellon. The other two were released from adherences and found to be in anatomical continuity were left in place. Immediate resolution of dysesthesia was referred by the patient and the amplitude of motion was complete at one-month postoperative control. She remains pain-free 4 months from surgery and the area of dysesthesia remains anesthetic at the center. Conclusions; Surgical identification and rerouting of the distal end of sensitive nerves is an efficient treatment after peripheral nerve injury.