@davidsinclair Thanks for the kind statement about the diagnosis, however, I want be clear that **I haven't diagnosed** anything about this issue. This information was totally retrieved from valid studies about this situation. The following information also has been researched the same way. Links to validate the following statements will be stated below for further references:

What the findings mean:

1. “Isolated severe left femoral nerve axonal problem”.

The femoral nerve (which powers the quadriceps and helps with knee extension and hip flexion) has suffered significant axonal damage.
Axonal injury means the actual nerve fibers are damaged—not just compressed or “stunned.”

2. “No sign of reinervation”
Reinervation means damaged nerves starting to reconnect with muscle.
At this point, testing shows no measurable regrowth or reconnection in the studied parts of the quadriceps.
This confirms the injury is not neuropraxia, which is the mildest and fastest-recovering nerve injury.

3. Prognosis: slow and possibly incomplete recovery.

With axonal femoral nerve injuries:

Recovery, if it occurs, is slow.
Often 12–24 months.
Recovery may be partial, not full.
Nerves regrow at roughly 1 mm per day, and muscle health must be preserved while waiting.

Why the lack of treatment is concerning (and why you’re right to worry).
You are correct to be concerned.

Key issue:
Even when nerves are slow to recover, muscle and joint function must be maintained, or permanent disability can occur even if the nerve eventually improves.

Without physio:
Quadriceps muscle can atrophy.
Knee can develop stiffness or instability.
Abnormal movement patterns can become permanent.
Pain and gait problems can worsen.
Physiotherapy does NOT require nerve recovery to begin.
It focuses on muscle preservation, joint mobility, safety, and compensation strategies.
The referral confusion (important point):

A neuro-physio refusing because they “only treat peripheral nerve injuries” makes no sense — the femoral nerve is a peripheral nerve.
This suggests a miscommunication, inappropriate triage, or local service limitation, not a medical contraindication.
The referral to a peripheral nerve specialist/plastic surgeon is appropriate because:

Severe axonal injuries sometimes require:

Surgical exploration.
Neurolysis (freeing the nerve).
Nerve grafting or transfer (in select cases).
However, surgical opinion does not replace physiotherapy.
What should be happening right now (best practice):

At 23 weeks post-op, standard care would usually include:

1. Immediate physiotherapy (non-negotiable).
Even without reinervation:
Passive and active-assisted quad work.
Hip flexor strengthening.
Knee stabilization.
Gait training.
Bracing assessment (e.g., knee brace to prevent buckling).

2. Regular neurophysiology follow-up
Repeat EMG/NCS every 3–6 months
Looking for any early signs of reinnervation.

3. Clear surgical timeline:
If no recovery by 6–9 months, many specialists consider:

Surgical exploration.
Intervention before muscle becomes irreversibly denervated.

Practical steps you can take now
Urgent actions:

Ask your neurologist (or GP) to:

Re-refer you explicitly to general neuro-rehabilitation or musculoskeletal physio.

State clearly: “Femoral nerve palsy with quadriceps weakness—physio for muscle preservation and gait safety”.

Request:
Written clarification on why physio was declined.
Expedited appointment with the peripheral nerve specialist.

If available:
Seek private physiotherapy temporarily (even 1–2 sessions can establish a home program).

Bottom line:

This is a serious femoral nerve injury, not a minor one.
Recovery can happen, but time is critical.
Lack of physiotherapy for 10+ weeks is not acceptable care for this condition.
You are absolutely right to advocate for yourself