Should I have knee replacement with neuropathy?

Wow! blessings to you, tomcatrv4! Amazing job on your knees!
Neuropathy, however, seems to be one other thing our
health”care” system has chosen to mostly ignore. I tried to make an appointment with Dr. Oaklander (found her during one of my multiple online searches: apparently she is recognized as the “guru” of neuropathy disorders). No way. Even if I wanted to wait a year or two! All I could get out of Mass. General Brigham in Boston was “our computer takes your info and assigns the best provider for you”.
You’re a trooper, tomcatrv4! Thank you so much for your inspiration! Tracy (ie: “Galactic”)

Hi Ed…gees….sounds tough! But you sound just as determined!….and that always works in one’s favor (in my humble opinion)!
Yes…I did alot of homework. My idiopathic peripheral neuropathy has not gotten to the point where my balance is being affected. However, my feet sometimes show me how the numbness was advancing in my feet: like when my nephew took me out on his boat and when I attempted to dive off, my toes gave out! my lower legs would have hit the edge of pontoon but something told me to bend my knees and so I ended up with a huge belly flop. The same day on way to car I asked my nephew if he could grab my phone in the boat (I accidentally left it…I thought). He said he had put my phone in my shoes…but I said no, I have my shoes on. Something clicked in my brain and I took off my shoes….there in the left shoe was my phone. That was in 2018. Progression has been slow (diagnosed in 2010. I am now 73). Bone on bone knee arthritis diagnosed 2 years ago.
I read as much medical literature that’s out there as I can.
I don’t know if you have any other health factors that would add concern to a good orthopedic surgeon (like heart disease, diabetes, muscle wasting, grossly over or under weight, etc…) but I do know I ended up with a surgeon I liked immediately but was still hoping I had made the right decision. TKR is a huge undertaking for the body. Sounds as though you have read all that’s “out there” as well.
I did end up going to a surgeon who was trained in “minimally invasive” (not robotic) TKR (also known as “Jiffy” TKR).
Each patient has their own health history that they bring to “the table” (quite literally) and each surgeon has his/her strengths. It is not easy to navigate today’s healthcare system. Sounds like you have tackled the big questions. Always look for that “open door” that may have new info and new answers. Take care, Ed. Will send a prayer “up there” just for you ⚡️☺️Tracy (ie: “Galactic33)

I empathize. Good luck to you! 22 years post bi-laeral TKR I am now 71. Both are doing great, but at the time, was rough going. F here, gender sex size knee replacements did not yet exist -at least were not available for me, so the overage caused terrible rubbing against soft tissue, nerves and ligaments. I also find it harder to get up now but 12 years ago had bilateral hips done. Now told need bilat reverse shoulders, and ankle surgery, also hand surgery to remove bone spurs as well as CPT surgery. I am going to try out SOFTWAVE therapy. Expensive, and ins won't pay but feel might be a good investment if it works for me. Look into it. There are several redlight therapies out there.

@galactic33 Hi Tracy - In my mid 70's, I do not have any health issues you referenced and quite honestly with the exception of my knee issues and PN, I am generally in good health. Very active until about 2015 when PN became an issue and in past 10 years, like many others, slow progression. I have tried to go to teaching hospitals over the years relating to both PN and knee problems and Mayo in MN being one of them. I have family members in the medical field and have always listened to their opinions. I can't say I followed their advice 100% but took what they said and, in most cases, applied what they suggested. My knee issues were minor until around 2021 when they became more serious. Of course, by then, my PN became worse as well. Had my knee issues became worse 10 years ago, it is likely I would have been a candidate for replacement at that time. Ed

Fingers crossed for some innovative discoveries and subsequent cure for neuropathy. My dad died at age 87. Had PN also. Spent the last few years of life in a wheelchair. There has to be something “just around the corner” for PN. 👍

I've read both that waiting until the pain in the knee is constant and excruciating is a bad idea, and that doing it earlier than that is unnecessary. I've bought a couple of decades with various measures and am running out of non-surgical options, so I've had two consultations for a TKR. I have mild scoliosis, which means that my weight landed off center on my hips and knees for most of my life -- for that reason, the left knee and the right hip are in the worst shape for me. In the end, the most deferral years came from weight loss and gait retraining. (Gait retraining for lower limb arthritis is having a moment, due to some recent research. If you have not explored it, you might want to consider doing so. It's important to find a PT who knows what they are doing in this specific area -- I found one at a PT practice that specializes in dancers. I've been sedentary for most of my life, so I was impressed that they took me seriously.)

In the end, I've decided to see if I can avoid the surgery entirely. Key to that decision were several factors, the most critical of which is my age. If I were not 73 and pretty much expecting to be dealing with dementia (family history) by my 80s, I would have gone with the surgery in spite of the neuropathy, because I'm confident I will never be in better shape for the surgery than I am now (I'm keeping several medical issues in balance right now, and have no reason to think things will get better instead of worse over the next decade). Other factors I took into account were my husband's health (it's going to be difficult for him to help me), our current house (it's really going to be difficult for him to help me, since our bedroom is on the second floor), and the difficulty I'm going to have sleeping (one of my issues is insomnia, I sleep on my stomach with my legs bent, and I'm told it's critical to sleep with the knee fully extended after surgery, which is going to be really hard for me to do and will probably force me into daily z-meds which will be very hard to stop). Also, I had a colonoscopy three weeks ago, and I'm still rebalancing from the dietary changes from the prep phase which threw me back into chronic migraines, so heaven knows what the surgery will do. If it was likely that I would have 15 or more good years left, dealing with the recovery for a year or two now would be worth it. As it is, I'm just going to gamble that I can continue to cobble together enough delay tactics to make it another decade, rather than take what might be a horrible year out of that decade now.

Keep in mind that most people would not be looking at an entire horrible year. Most people will have an excellent TKR experience (although honestly, I think people who do both knees at the same time are nuts). Those people are unlikely to be engaging on this blog, so take into account the probability that what you are seeing here is statistically skewed insight, including mine.

And really, check out gait retraining. It's a really big behavioral change, so it requires a willingness to persist for a good six months to modify your habitual walk. And in my case, included a period wearing a hip brace under my clothes to help fix the torque. But it also unexpectedly got me off the orthotics I've been wearing for a couple of decades. Just made a huge difference to my entire lower body. Who knew?

I had my left knee done last August and the right one done in March. I did not notice any correlation to neuropathy pain. I am 85 and did very well with the surgeries. I did wait until the knee pain was bad. I had already had 3 lumbar surgeries and 4 hip replacements and was surprised that the recovery was not as bad as anticipated based on what others told me. Just be sure you have a good surgeon (base on results others have had) and a great physical therapist (same way of choosing) Start therapy either before surgery or immediately after. Makes all the difference in recovery
I recently raised my gabapentin to 1200 a day and my alpha lipo to 1200 a day and have had marked improvement in pain level

GREAT idea, hray1948! I read about this and also looked it up on You Tube! Forgot about this!
I was looking into in but didnt get far because, for me, it would have been ALOT out of pocket! (easily 10 Grand)…but maybe now the stem cell treatment has gained some respect (and therefore: “reimbursement”)
So much technology happening out there……needs to make it to the common human more quickly👍🤞😌

Please see my “too long but thorough” experience with TKR
(posted a few days ago) in the setting of Peripheral Neuropathy. Had both knees done (Minimally invasive “Jiffy” knee), 6 weeks apart: the left side was the most painful, had a limp. I sailed thru that! The right knee was stubborn! Had some pain from neuropathy in that leg…never the left. I dont actually have any other symptoms of neuropathy, just numbness in toes and parts of feet.
Good Luck, mwutke! Follow your heart….you will find the decision best for you❣️

I've had neuropathy 12 yesterday now and had knee replacement 2 years ago. Also torn mml 10 years ago. Having neuropathy was of no concern of the surgeon who just made a mental note, no more