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Tom Bragiel has never been one to sit still for long. The Wilmette husband and father of two also is a lifelong athlete, who spends his spare time playing basketball with the guys, golfing, biking, fishing, boating and hiking.
But in March 2016, the 54-year-old Bragiel’s active life came to a standstill. While shooting hoops one afternoon, he tore his meniscus—the cartilage between the shin and thigh bone. A surgical repair was the best option to get him back in the game.
Persistent Pain NorthShore-affiliated Orthopaedic Surgeon Greg Portland, MD, performed two separate arthroscopic surgeries to treat Bragiel’s painful tear, hoping to get him off the sidelines. But to no avail, the discomfort continued.
“My knee still didn’t feel right. I had a sharp pain with certain movements and couldn’t be as active as I used to be,” recalled Bragiel, who went through extensive physical therapy and rehabilitation postsurgery.
After giving it more time to heal, Dr. Portland began to suspect an atypical cause of the pain based on its type and location just below the knee. It turned out to be inflammation related to Bragiel’s saphenous nerve. So, Dr. Portland referred his patient to NorthShore Plastic Surgeon Michael Howard, MD. Both specialists hold academic appointments at the University of Chicago Pritzker School of Medicine.
“I couldn’t believe a plastic surgeon could relieve my knee pain,” said Bragiel. But that’s exactly what happened.”
Nerve Repositioning “Tom’s pain was consistent with a nerve pathway running alongside his inner right knee,” noted Dr. Howard, whose practice includes peripheral nerve surgery. He noted that nerve branches can be damaged with compression, or the kind of twisting injury Bragiel suffered, causing the lingering pain.
In outpatient surgery last April, Dr. Howard repositioned the painful nerve branches in Bragiel’s knee in an innovative procedure called targeted muscle reinnervation (TMR). “Basically, TMR interrupts the nerve pathway or signal that the brain senses as pain,” explained Dr. Howard. The procedure also can be effective for patients with pain in other parts of the body, including the groin, hand, elbow, shoulder and foot.
NorthShore is one of only a handful of health systems in Chicagoland championing this new area of medicine with a multidisciplinary approach. Dr. Howard works closely with the NorthShore Pain Clinic, and collaborates with colleagues in Neurosurgery, Orthopaedics, Podiatry and Obstetrics and Gynecology to achieve the best outcomes possible for patients.
“Dr. Howard’s skill gave me immediate relief, and now my knee is pain-free,” emphasized Bragiel. “It’s taken time to get used to a feeling of numbness in my knee from the TMR, but I’m happy to be back doing all the things I love.”