Question
Hi.  My mom is 74 years old and has arthrogryposis.  Eight days ago she had total knee replacement surgery.  A nerve in the back of her knee was stretched during the surgery.  I guess this is routine, but since her leg was much more crooked than normal (due to her arthrogryposis), this nerve was stretched more than normal.  I'm not sure the name of this nerve (perovial, spelling?).  The doctor said this nerve is responsible for feeling at the top of the foot and the shin area.  My question is, is there anything we can do to speed up nerve regeneration?  Since the operation, she hasn't had any feeling in her foot, but she does have feeling in her thigh.  The top of her foot and the top of her shin doesn't have any feeling(it's kind of numb). So, because of this, her foot drops down (it's a "drop foot" now).

Thanks so much!!

David

Answer
Hi David-

I assume you (and the doctor quoted) are referring to the peroneal nerve, although in the context of your question it won't affect my answer very much.

The stretching of a nerve, without structural damage, results in a form of "neurapraxia", which is similar to a bruising of the nerve.  A neurapraxia heals at varying rates, dependent upon the degree of damage, whether or not the damaging factor(s) have been totally eliminated, the patient's age, and other factors such as the presence of proper nutrition and whether or not any systemic disorders (diabetes, anemia, etc.) are present.

If the nerve has structural damage, it is possible to achieve regrowth, but the potential outcomes are less promising.  Peripheral nerves can regrow, and heal themselves, so there's probably a better than fair chance your mother's problem will resolve, at least in part.  Stressing the fact that healing and/or regrowth are dependent on a number of factors, it's possible that this "rewiring" will occur at the rate of about one millimeter per day - around an inch per month - which is the typical rate of peripheral nerve regrowth at this area of the body.  In other words, it's possible that she (and you) won't see the final outcome for several months.

Proper diet is important.  Speak with her physician (who has knowledge about any co-existing conditions) about his/her thoughts regarding specific nutritional aspects in this situation, especially in the B vitamin family...

Last, try to keep your mother as active as possible - this will aid in the regrowth and/or healing rates.  Hope this helps; if you have any other questions, please feel free to ask.