Knee replacement with neuropathy in legs

Posted by tcokeefe @tcokeefe, Aug 12, 2019

I have bone on bone arthritis in one knee and have been told I will probably need a knee replacement in the near future. I also have advanced peripheral neuropathy in both legs. Several years ago I had bunion surgery, and the nerves in one foot in the big toe were completely dead after the surgery and the toe is deader than a door Nail and the toe has no muscle control and crosses over worse than before surgery. Anyway, my fear is having any further nerve damage as a result of knee surgery, and have read articles where some people who had neuropathy have ended up with foot drop as a result of nerve damage from knee replacement surgery. This really scares me because I’m afraid I would end up without the use of my leg or end up with extreme difficulty walking as a result of trying to improve my knee pain. Has anyone out there had a knee replacement who also had advanced neuropathy in their leg?

Interested in more discussions like this? Go to the Neuropathy Support Group.

Hello @tcokeefe, Welcome to Connect. I had a total knee replacement on my right knee this past April. I also had similar concerns since I have small fiber peripheral neuropathy. There is alway a risk of nerve damage and it's a good thing to discuss with the surgeon and the care team. The anesthesiologist explained the risks prior to the knee replacement. I would definitely talk to your surgeon and have them explain the risks. Here's an article that kind of explains the risk.

Tourniquet cuff pressure and nerve injury in knee arthroplasty in a bloodless field
-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639336/

You may want to join the following discussion where you can meet other members who have shared their knee replacement surgery experience.

> Groups > Joint Replacements > My Knee Replacement Surgery Experience
-- https://connect.mayoclinic.org/discussion/my-knee-replacement-surgery-experience/

Have you talked to your surgeon about your risk of nerve damage? I'm tagging @JustinMcClanahan @debbraw and @contentandwell to see if they have any experience they can share with you.

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Thanks so much, John! I appreciate the info and links! I've also been reading that Mayo is working towards safe stem cell for knees and hope maybe I can hold out with cortisone and/or gel until that becomes a viable option to surgery!

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I had both knees replaced 10 years ago. Best thing I ever did at the time. I was very active and my knees wore out with skiing, biking and running. The surgery got me back to everything except running. I am now 69 years old. I had a little numbness in both my feet prior to the surgery and it got a little worse every year after. A year ago both feet dropped and I am 80 % numb below my knees in both legs. I have little balance and need braces and a cain to walk. Falling is a problem. The good news is I have no pain. Is my condition due to the surgery 10 years ago? I think the knee replacements had some effect on my condition but the doctors aren't 100% sure. I have tried a number of remedies to try to get feeling back with no success. Anyone out there have any ideas?

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@ericvnelson

I had both knees replaced 10 years ago. Best thing I ever did at the time. I was very active and my knees wore out with skiing, biking and running. The surgery got me back to everything except running. I am now 69 years old. I had a little numbness in both my feet prior to the surgery and it got a little worse every year after. A year ago both feet dropped and I am 80 % numb below my knees in both legs. I have little balance and need braces and a cain to walk. Falling is a problem. The good news is I have no pain. Is my condition due to the surgery 10 years ago? I think the knee replacements had some effect on my condition but the doctors aren't 100% sure. I have tried a number of remedies to try to get feeling back with no success. Anyone out there have any ideas?

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I'm so sorry about your situation! This is the problem with neurological issues so much of the time: there's no real way to know why it started, when it started, what may or may not have caused it..... I wish I had heard of a remedy but I haven't. My neuropathy is progressive and has gone from mild numbness in my one ankle to full-bore pain/numbness 24/7 in both legs from soles of my feet to my hips. Walking is painful but I can still walk, and I am very grateful for that. I hope you find some help and if you do, please post it everywhere!!! Thanks for sharing your story!

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@ericvnelson

I had both knees replaced 10 years ago. Best thing I ever did at the time. I was very active and my knees wore out with skiing, biking and running. The surgery got me back to everything except running. I am now 69 years old. I had a little numbness in both my feet prior to the surgery and it got a little worse every year after. A year ago both feet dropped and I am 80 % numb below my knees in both legs. I have little balance and need braces and a cain to walk. Falling is a problem. The good news is I have no pain. Is my condition due to the surgery 10 years ago? I think the knee replacements had some effect on my condition but the doctors aren't 100% sure. I have tried a number of remedies to try to get feeling back with no success. Anyone out there have any ideas?

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Hi Eric @ericvnelson, I had my right knee replaced in April. I have idiopathic small fiber peripheral neuropathy without the pain, only have the numbness. Currently it is in both legs and a little above the ankles. I take supplements I found through a closed Facebook group. I posted my PN story earlier on Connect here: https://connect.mayoclinic.org/discussion/anyone-here-dealing-with-peripheral-neuropathy/?pg=42#comment-65985

I too have balance issues and a little trouble walking for very far due to what I think is lower back problems - degenerative disc disease. I am planning to try Myofascial Release Therapy as soon as I can find a therapist close to where I live. It does sound promising for relieving some of the numbness from people who have had the therapy. You might want to look into the discussion here on Connect.

> Groups > Neuropathy > Myofascial Release Therapy (MFR) for treating compression and pain
-- https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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Welcome to Connect, @tcokeefe As @johnbishop said, I have also had two TKRs. I am one of the fortunate ones who has never had nerve problems, or tightness around the knees after surgery. I did have extreme pain that reduced me to tears a few times after the second surgery, but it passed in six of seven weeks and all has been great since then. After my second TKR I was able to resume a very active life with quite a bit of exercise and walking. If you proceed with having a TKR I would suggest that you thoroughly research the surgeon. I firmly believe that makes a huge difference. I have never heard of anyone not having a great recovery from a TKR with the surgeon I used.

@ericvnelson I am so sorry to hear what you are going through. You have obviously been a very active person so this must be doubly hard on you to have such a problem. I hope you manage to find some help with it.
JK

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I am 67 years old and have bone on bone in both knees. I need knees replaced but am told by a number of surgeons that I will have difficulty in rehab due to neuropathy in legs from failed lumbar decompression surgery in 2012. Does anyone know of special rehab program to help me. My knee pain is almost unbearable.

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@catherineloretta

I am 67 years old and have bone on bone in both knees. I need knees replaced but am told by a number of surgeons that I will have difficulty in rehab due to neuropathy in legs from failed lumbar decompression surgery in 2012. Does anyone know of special rehab program to help me. My knee pain is almost unbearable.

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Hello @catherineloretta, Welcome to Mayo Clinic Connect. You will notice that we have moved your post to this discussion on the same topic. If you click the VIEW & REPLY button it will take you to the discussion where your post was merged.

I also have small fiber peripheral neuropathy in both legs but I only have numbness associated with the neuropathy. I had my right knee replaced in April of last year and I had no problem with rehab which I did at home. My other knee is not bone on bone yet but it's really close and not bothering me like the right one did. Like you the knee was my primary source of pain and at times quite bad. The knee replacement took care of the pain. One of the things that helped my rehab was having an exercise bike at home which I used for short periods of time several times a day.

I am 77 and was a little worried about the neuropathy getting worse but I am really happy I had the surgery done. Have you considered getting another opinion or seeking help at a major teaching hospital or the Mayo Clinic? If you would like to seek help from Mayo Clinic, contact one of the appointment offices. The contact information for Minnesota, Arizona and Florida can be found here http://mayocl.in/1mtmR63.

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I am 73 and scheduled for knee replacement in July. I have had idiopathic peripheral neuropathy in that leg for six years. I wonder if that can be "fixed" during the surgery. And I also wonder if the surgery could make it worse in long term. Thanks for replies.

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@johnbishop

Hello @catherineloretta, Welcome to Mayo Clinic Connect. You will notice that we have moved your post to this discussion on the same topic. If you click the VIEW & REPLY button it will take you to the discussion where your post was merged.

I also have small fiber peripheral neuropathy in both legs but I only have numbness associated with the neuropathy. I had my right knee replaced in April of last year and I had no problem with rehab which I did at home. My other knee is not bone on bone yet but it's really close and not bothering me like the right one did. Like you the knee was my primary source of pain and at times quite bad. The knee replacement took care of the pain. One of the things that helped my rehab was having an exercise bike at home which I used for short periods of time several times a day.

I am 77 and was a little worried about the neuropathy getting worse but I am really happy I had the surgery done. Have you considered getting another opinion or seeking help at a major teaching hospital or the Mayo Clinic? If you would like to seek help from Mayo Clinic, contact one of the appointment offices. The contact information for Minnesota, Arizona and Florida can be found here http://mayocl.in/1mtmR63.

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Hello @johnbishop,
I plan on this being a good day. I will see my surgeon in a few hours for my postoperative appointment after TKR performed May 2. We are all a combination of health concerns. I wondered what the heck I should do because both my knees were bone on bone, I have beginning neuropathy and spinal stenosis. My surgeon urged me to get TKR. He said my back may improve with more exercise. So far TKR is going well, no complications. I don't regret it. I knew I needed relief somewhere. I just am interested in how others cope with multiple things going on with their aging bodies. I am 76 yr old female who wants to be active and this seemed my best option to get there. I like Mayo Connect. I have already had compassionate replies tgat helped me get through these first 2 weeks...definitely not easy for me. Sheryl

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