Should I have knee replacement with neuropathy?

Posted by susiesprue @susiesprue, May 6, 2023

I have idiopathic neuropathy, in my feet and legs, stiff, tingling, burning cramping at night, the usual, and I have painful arthritic knees. Hyluronic acid did not work, considering prp therapy. Has anyone been successful in knee replacement as a diagnosed neuropathy patient? If not suggested, what would one do?

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jchet | @jchet | May 21 10:14am

In reply to @davidpn "Hi Chris, I’m in Glenview just north of Chicago. Use to do many lakefront bike rides..." + (show)

I have the same issues as you with your feet. Have you ever had COVID? My issues with SFPN seemed to have increased since I had it. I’m really thinking my worsening symptoms of fatigue and shortness of breath are after effects of having COVID for the first time. There’s no blood test to determine an answer, but I seriously think I have chronic fatigue syndrome as a result. That along with SFPN leave me with very little energy.

liloldlady | @liloldlady | May 21 10:52am

In reply to @davidpn "Hi Chris, I’m in Glenview just north of Chicago. Use to do many lakefront bike rides..." + (show)

this is going to sound a bit weird, but, here goes. For several months, when i walked simply from a parking lot, into the store, and i did park sort as far away as i could, to make me walk, but even that short distance, when i was 1/2 way to the store, i was huffin and puffin, and felt like shortness of breath. This was going on for may months. I didn't worry tooooo much, because, my daily activities is mainly sitting down, playing cards in a rec center. BUT.........one day, i had to have an ultrasound. It took about 20 or more minutes to do. The gal, had me breathe as deep as i could and HOLD my breath , she always said, ok , you can breathe, which was right up to the point where i would have had to , with, or without her permission. She had to turn me on my sides, and i had many many minutes of holding my breathe. Strange part............when i got out of there, i noticed immediately, that my breathing was better, and i was able to walk farther without huffin and puffin. so for a few days, before starting my day, i did the hold your breathe, altho, i did not do it for 20 minutes. But i would take maybe 6 or 7 deep breathes and hold . Since then, i haven't felt that heavy feeling in my chest. Ok, granted, this is not going to cure a medical problem, but, it did help my heavy chest feeling of being tired from walking just a short distance. My thoughts, if it might help even a tiny tiny bit, for someone..........then maybe this silly little thing, of holding your breathe, will be helpful to someone. Nice thing, no needles, no drugs, and if it doesn't work for you.........it was easy enough to try. I understand there are medical problems with lungs, etc., that this will most likely not help. But, this simple little thing might help someone, and is so simple you could try it right now, while you are reading these comments on this website..........

lynfrommn | @lynfrommn | May 21 1:42pm

In reply to @pumpiron3 "I have had both knees replaced. No change in Neuropathy" + (show)

I've had a total hip replacement (left leg) and total knee replacement (right leg) in the last 3 years. Neither has changed the symptoms of ideopathic peripheral neuropathy I've had for the last 7 years.

lakelariet | @lakelariet | May 22 11:15am

In reply to @jakefix82 "I have idiopathic PN, diagnosed about 3 years ago when I explained to my new PCP..." + (show)

@jakefix82

I have idiopathic PN, diagnosed about 3 years ago when I explained to my new PCP (primary care provider) that my muscle aches felt different from the fibromyalgia aches diagnosed 40+ years ago in my mid-thirties. Am 75 now, PCP that I loved is now deceased. Anyway, I got a full neurological work up, bloodwork, etc, since it’s been 40 years. They diagnosed idiopathic PN. I’ve used an old muscle relaxer on an at needed basis for the fibro for 30 years and still use it - rarely use a OTC pain med. However, for several years now, I’ve found I get stiff as cardboard and can hardly move my legs/feet (have to shuffle them) if I go 2-3 days on less than 8 hrs of sleep. I attribute this to the PN because doctors are clueless and it makes sense to me. The debilitating stiffness is an established pattern, so when I suddenly become stiff (it comes on quickly), I know why. Always not enough sleep. People with post polio syndrome also experience this - their nerves over-compensated for years after childhood paralytic polio and when older, the nerves are just shot. They’re told to rest and don’t overdo exercising. I didn’t have polio, but my symptoms are the same and resolve with rest. Sometimes it takes a few days - lots of rest - to restore the nerve conduction. I’m guessing the nerves are just in overdrive to fire up my muscles - and boom! they can quit suddenly! However, I now have bone on bone OA in left knee - and that knee also gets inflamed because I have a congenital condition discovered during imaging for something else. It’s called bipartite patella - essentially the cartilage that’s supposed to fuse together to make a one bone knee cap during childhood never happened. About 1% of people have this - the two bones are held together with connective tissue that as I age with wear and tear, gets inflamed. I’m overweight, pre-diabetic. Exercise has been hard for me since the fibro diagnosis - I get what’s called “post exertion malaise” after exercising,
one’s entire body feels like the flu. I think it’s the nerves in overdrive, a reaction to exercising. They finally gave a name to this “malaise” a few years ago. I see an orthopedist next week about this OA. I’m not in too much pain - this knee flared up after I decided to try exercising in a warm water therapy pool last month. The knee bends and leg kicks were too much on this knee and I could hardly walk. Imaging revealed bone-on-bone OA. Have been watching videos and doing leg exercises on my own and wear a neoprene brace. Can walk as much as 30 minutes to do grocery shopping or walk around Target - then legs give out because muscles are working hard to stabilize that weak knee. I’m seriously debating if TKR is right for me - the Dr may say no. I’ve not had to take any injections. At 75, with relatively little pain, a rather sedentary life style because I tire easily, I’m still able to do housework and live independently I’m afraid TKR might end all that if it doesn’t work for me. When I hear people say TKR interferes with sleep the first few weeks, I know that means my muscles won’t work because of the PN. Lots to think about! But I think your tiredness is due to PN, as I really think mine is.

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Of course everyone is different, but I am 85 & just had my 2nd total knee replacement.
It was not nearly as painful as I had been told. I have had several hip replacements.
The hips have been much more limiting than the knees.
I was diagnosed with fibro 40 years ago but have not been treated for 30 years and dont know if that is affecting the neuropathy. I use gabapentin which I am increasing to 900mg because
neuropathy is increasingly painful. Have also had 3 back laminectomies so dont know if hip or back surgeries are reason for neuropathy. You sound as if you are doing well with keeping up with daily life. God bless

galactic33 | @galactic33 | Aug 29 6:44am

In reply to @johut "I am 77 and have idiopathic peripheral neuropathy and had a minimally invasive TKR July 25,..." + (show)

THANK YOU again for your beautiful, thorough and detailed history of your Jiffy Knee replacement. Your detailed history inspired me and led me thru unexpected events to a “Jiffy” knee replacement.
My Follow up:
I had bone on bone OA both knees. Had a difficult time finding a surgeon I “felt” was right for me. (Worked as a PA for 39 years, retired in 2018.). In 2024 I noticed I have muscle wasting right knee greater than left and requested a Physical Therapy consult to help me strengthen my knees for eventual TKR. (my PCP is in Massachusetts and I had moved to a place on a lake in NH after retiring, so my PT ended up being in NH). During that time a huge family emergency took me away from PT as I cared for a loved one (and still do) after a series of serious surgeries. During that time I developed worsening pain left knee and began to limp. The last thing the PT offered was the name of the only surgeon in NH that does Jiffy (minimally invasive) TKRs. Finally I was able to drive the 1.5 hours to his practice. Long story short : I knew he was the one I would allow to operate on me. After 2 cancellations on my part, (more emergency surgeries for my loved one) my left knee (the knee that limped”) had the “Jiffy” knee replacement on June 17, 2025 and the right knee was done on July 29, 2025.
(yes, the “Jiffy” knee, which IS a TOTAL knee replacement is considered “minimally invasive” because the incision is a little smaller, more medial, and the quadriceps tendon is not cut, but retracted. Apparently this allows for a quicker recovery).
By POD#3 I was walking without the walker and walking the stairs one at a time. By POD #10 I was driving, running errands, etc. POD# 13 I walked 3/4 mile with a neighbor on an even trail by the lake.
THE RIGHT LEG WAS A MUCH DIFFERENT STORY.
Neuropathy to blame. In recovery room I knew it felt different. Much worse pain as hours went by. I did not feel well until about POD#5 or 6. I am 30 days post op, driving, walking, going up and down stairs, although I am much more careful with “down”. Neurontin at bedtime helps but I feel drugged the next day, so I stopped taking. Aches, pains, tingling, the click of the kneecap as I walk is intermittent. Swelling continues to improve (so slow!). The worst pain was on the outside of my knee, over the head of the fibula area. Easing up now. I do my exercises, still going to outpatient rehab, walk quite a bit, ice the knee.
As you have noted in your excellent reply, it takes time and dedication. I am looking forward to the six month mark.

I was surprised that one knee could be so stellar and the other was fraught with issues.
Sending you Best Wishes and Blessings. Tracy

hray1948 | @hray1948 | Aug 30 8:20am

My right knee replacement in 2018 aggravated my right foot Neuropathy. Depending on the condition of your biological knee, I would consider looking into stem cell treatment.

NJ Ed | @njed | Aug 30 8:50am

In reply to @galactic33 "THANK YOU again for your beautiful, thorough and detailed history of your Jiffy Knee replacement. Your..." + (show)

@galactic33

I was surprised that one knee could be so stellar and the other was fraught with issues.
Sending you Best Wishes and Blessings. Tracy

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@galactic33 Hi - It seems you have done your homework prior to surgery. I have PN, idiopathic axonal sensory motor no pain, mostly numbness and my balance is challenging. I walk with a cane about 70% of the time. X-rays show bone on bone both knees. Pain reduced with Advil, no stomach issues. I also get cortisone shots every 5 - 6 months. I inquired about knee replacement and 2 orthopedic surgeons, one with a large hospital both said no. Their concern was me falling due to PN and damaging the knee. Both said I'd be in worse shape if I landed on the knee causing severe damage to bone. My question is, why is my situation different from yours? Did you have numbness or balance issues? Ed

tomcatrv4 | @tomcatrv4 | Aug 30 11:37am

In reply to @galactic33 "THANK YOU again for your beautiful, thorough and detailed history of your Jiffy Knee replacement. Your..." + (show)

@galactic33

I was surprised that one knee could be so stellar and the other was fraught with issues.
Sending you Best Wishes and Blessings. Tracy

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I am 88 and had both knees replaced years ago, left one still fine, right one still fine mechanical y, but constant pain from what I now believe is increasing neuropathy.
Gabapentin 100: 3x a day, hydrocodone 7.5 4 x a day, and
moving around with cane

islandfrog | @islandfrog | Aug 30 12:46pm

I had a knee replacement in January. My neuropathy (feet) did get worse. I can't say if there is a cause and effect. I am having more issues with my knee than the neuropathy.

mwutke | @mwutke | Aug 31 6:29am

I'm scheduled for TKR in two months. Is there anyone that has not experienced increased neuropathy and or pain after recovery from the surgery? With so many negative comments I'm starting to think I should reconsider going through the surgery as I really don't have pain from the neuropathy at this point and most of the time the knee pain isn't too bad. However, I was told that I would likely start having hip and back problems if I let the knee can you continue to deteriorate.