Ask a doctor on the topic of Orthopedics

ACL surgery Nerve injured? Numbness

May 25, 2015 | 25,00 EUR | answered by Dr. med. Ive Dr. Schaaf

25.05.15 05:20
Hello,
I am 35 years old and I am currently writing from the hospital because I am feeling lost and in need of advice.
Some time ago, I twisted my right knee during sports and the diagnosis was not pleasant for me as a sporty person - a torn anterior cruciate ligament! Since my knee was extremely unstable afterwards, I decided to undergo a surgery in which the anterior cruciate ligament would be replaced by my own semitendinosus tendon. Additionally, the partially torn meniscus would be partially removed.
On Friday, 22.05.2015 around noon, the surgery took place and I was back in my room in the afternoon. I was in pain and my right leg was numb.
In the early evening, the orthopedic surgeon who operated on me came and reported a successful and complication-free surgery. When I asked him when the numbness in my leg would go away, he said that the feeling would return late in the evening or during the night. He then bid farewell for the Pentecost holidays.
The next day, I noticed the numbness slowly fading away and I regained feeling in my operated leg. Until the evening of the following day, my upper/lower thigh and the knee wrapped in a bandage felt normal, only everything below the knee was numb.
I realized the numbness was going away as I could now move my foot and toes, but the skin below the knee remained numb.
I was scheduled to be discharged on Sunday and decided to wait, especially since the nurses said that numbness was normal. After a sleepless night in which I worried about the numbness, there was no improvement. By now it was Pentecost Sunday (two days after the surgery) and I told the nurse that I still had no feeling below the knee. She informed the attending physician on duty, who came to my room after a few hours. She said that I shouldn't worry and that the numbness would go away. The knee was swollen and therefore the peripheral nerve block anesthesia was slowly wearing off. I was advised to stay for observation for another day.
Hours passed and now it is Pentecost Monday (still a holiday where no one seems to be properly on duty) and there has been no improvement. If it was the anesthetic wearing off, there should have been at least a slight noticeable improvement within a day. I am now afraid that a nerve was damaged during the surgery and that it will remain like this;-( I can move my foot in all directions, but if someone scratches me below the knee, I feel nothing. It is a scary feeling, especially since I don't know how to do the rehabilitation. I can't feel when I step and I'm not allowed to put weight on the knee.
Now I am lying in bed and could cry. The discharge papers have been on the table since yesterday, stating that everything went smoothly. Then a prescription for physiotherapy twice a week, nothing else. Was that it? I always read that physiotherapy is very important and that everything starts the day after the surgery, but no one is here. I am lying in bed almost all the time. I am now waiting for the early shift of the nurses to come in so I can tell them and hopefully another doctor will come up after a few hours;-( How long will this go on? I have read that if nerves are damaged, action should be taken quickly... Shouldn't a neurologist (there is none at the hospital) look at this?
This delaying or downplaying is making me feel completely overwhelmed...
I don't know what to do?
Best regards

Dr. med. Ive Dr. Schaaf

Good morning,

You are absolutely right that you should be neurologically examined as soon as possible.

There are two possibilities: either a nerve was irritated at the level of the spine during the spinal anesthesia, or a nerve was irritated at the level of the knee. This would need to be clarified through an appropriate clinical examination - by a neurologist or someone who can perform this examination.

In your place, I would proceed as follows:
1. You now need a witness for all further steps, preferably someone from outside, but it can also be your roommate if they agree. It is also helpful to record all conversations.

2. You call the nurse and explain to her IN FRONT OF A WITNESS that you request a visit and examination by the hospital's chief physician or their representative within an hour, otherwise you will sue the hospital for failure to provide assistance.

3. Get the doctor's findings in writing. If no doctor comes, note this in front of witnesses.

4. IMPORTANT: Make sure - and insist on it - that you are given a COPY of your COMPLETE medical records. Also tell this to the nurse immediately in front of witnesses and do not let yourself be put off. You will have to pay for the copies, about 10 cents per page. IMPORTANT: The doctor must confirm in writing that the COMPLETE records have been handed over to you.

4. Go to a clinic with a neurological department and get examined. Take a witness with you, who should also be present during all examinations, and then get the findings in writing.

Then you should know what to do next, if not, please contact me again.

Best regards,

Dr. Schaaf