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What are the dangers from being unable to feel pain after knee RFA?

Johnny2B

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I have yet to see a presentation on potential dangers from not perceiving pain signals after an RFA. How can I know when I have over extended and traumatized tissue in the regions made insensitive by the RFA procedure? Is that a potential matter of serious concerns? I think so and will soon bring this up with my treating physician.

Two hours after my test block for determining the likelihood of RFA success, I walked briskly for 30 minutes without discomfort, then used my stationary bicycle for 15 minutes.
Prior to the receiving the anesthetic, I was unable to stand for more than 5 minutes without hiking poles for support, and with the poles, walking was slow and limited to 15 minutes before having to take an opiate; similarly, I was unable to use my cycle for move that four revolutions.
I slept for a full 8 hours which had not been done for years.

However, the next three days were spent in bed with a painful stiff knee and aching leg even though it was elevated 45 degrees. I did not ice after the extraordinary activities because I felt then no discomfort. Moreover, my leg and knee were both felt and measurably cooler than normal the next morning. The block lasted about 12 hours.

By intentions, my opiate regime does not eliminate all sensations of pain, although 75mcg of Duragesic 24/7 and 4mg of hydromorphone 3 to 4 daily is required to be normally functional. Hydromorphone was not required the day of the test block. However, the day after the procedure, the full opiate regime was not sufficient to permit functionality for two subsequent days. (after the day of my extraordinary post procedure activities that were permitted by the absence of pain)

In question are, is my response typical, and how best to monitor potential tissue trauma after an RFA in the knee? The nerves in my knee region are characterized by my orthopedic surgeon as severely inflamed and highly entrapped.
During the past 4 years, my passive ROM has steadily decreased from a previous 0 & 137 to 17 & 54 degrees. Help!!!
Would an open knee surgery that un-trapped the nerves and removed the ROM limiting adhesions be more appropriate? Would elevation and a 24/7 compression ice pack, 20 on 20 off, sufficiently inhibit the production of collagen to ward off excessive scar tissue formation? Is there now a looming procedural protocol for inhibiting the growth of adhesions?

I have been on meds for 16 years and want to have a fuller life. Three knee revisions were done in effort to eliminate pain, but they only made me worse. The problem was nerve inflammation, likely exacerbated by my hypermobility and to the inattention to clogged lymph vessels until three years after the last revision. The lymphatic massage eliminated years of hot redness and the swelling was reduced by a circumference of 3.5 inches.
 
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Jamie

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Hi, Johnny and welcome to BoneSmart.

You are asking questions that really only your surgeon and possibly your neurologist are going to be able to answer for you. They are the ones who are familiar with the details of your case....at least that's the case now until we know more about you and your medical history.

Here are some of the things that would be helpful for us to know:

What is your correct age? The information in your profile indicates you are 22 and that is obviously not correct. Your age makes a difference in what advice we might be able to provide.

What were the dates and descriptions of each of your surgical procedures with your knee? You've posted in the Knee Pre-Op forum, but your posts sounds as if you've already had a knee replacement and have had multiple revisions.

What circumstances resulted in your TKR and each of your revisions?

If you can provide this information, it will be a good starting point for us to try and understand what you've experienced up to now.
 

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