Foot neuropathy (numbness and pain) after total knee replacement (TKR)

Posted by norby @norby, Nov 26, 2018

I had a right total knee replacement 10 weeks ago and came out of surgery with numbness and intermittent pain on the bottom of my right foot. However, I do have good motor function in that foot. The knee has been healing and with PT, movement is on track, but the foot is a major challenge. The foot pain at times is worse than any from the knee. I have been able to generally manage the foot pain with gabapentin. My surgeon believes this may resolve in time but may take from 6-12 months. However there is a possibility that it will never go away. Has anyone else experienced foot neuropathy following knee replacement? If so, what was your experience with it?

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Ouch! I moved into a 55+ community just prior to my TKR, and it seems like everyone I've met has had at least one TKR! They are all walking around good as new! I had mine 14 months ago. I had a tight feeling running across my knee from top to bottom, like a band, and an odd sensation across the ball of my foot like it was in a stirrup, but no foot pain or loss of sensation in my foot. That lasted for about 9 months! Years ago, I had metatarsalgia in my right foot, which felt like walking around with a hard pea under the ball of my foot. The first cortisone injection only helped for a couple of weeks. The second injection went right into a nerve and caused pain and numbness in the ball of my foot that gradually faded away, but it took about 3 years! I'm wondering if some of the pain people are describing here is due to something like that, rather than from the actual TKR.

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I just had my 2nd left knee replacement due to the 1 st doc used a 20 yr old component & and I couldn't walk on it fro a yr! Now the replacement I have a very Sharpe pain coming from my foot up thru my chin to my knee! I could be just laying on the bed or couch in major pain no matter what I take it will not stop any suggestions? ChiBob

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Its 6am in Chi as I write this, I ]m having MAJOR pain from my foot through my shin with no relief and don't know what to do? I don't see my surgeon again in 3 weeks. All this after my 2nd TKR on the same knee within a year.
Is anyone having the same problem?

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10 months after very difficult TKR I developed Tarsal tunnel syndrome, no pain but bad numbness and tingling.
Its a trapped nerve in the ankle similar to Carpal tunnel.

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I had numb and sharp pains in my feet for a few weeks .
(I had double knee replacements )

I wore no shoes or socks and soaked my feet in Epson salt and had hubby rub lotion on them .

Eventually I could wear sandles and now I’m wearing soft slip in sketchers .

Physio said as long as I had sensations in my feet to give it time

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Profile picture for robinleslie @robinleslie

10 months after very difficult TKR I developed Tarsal tunnel syndrome, no pain but bad numbness and tingling.
Its a trapped nerve in the ankle similar to Carpal tunnel.

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Have you been diagnosed? I thought mine was tarsal tunnel syndrome after tkr, then had surgery for it to find out 9 months later, that my nerve damage problem is higher up. I have pain with it as well.

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Profile picture for mackad2024 @mackad2024

Hi, All,
I'm coming in on the end of this conversation. I'll share my situation from my LTHR last March 2023. I went to a a highly reputable ortho. Within a week after surgery, the nerves around my left kneecap area were on fire, like red ants. I had to make a tent with pillows to prevent the sheet from touching my knee as it was seriously painful and I cried. The PA said should clear up in a few months. It did not, but the fire ants and nerves began to be less painful. Then the ortho said it could take 18 months. This month is 18 months. What I have been left with is numbness in thigh from top of knee and on the side nerves. For many months, I had electrical shock feeling in those areas, doctor said that's good b/c nerves regenerating. Now I still have the numbness top of thigh and on side nerve-like sensations and that hurts I bump against something. Sleeping on that side can be uncomfortable. I have a feeling I may just have to live with this the rest of my life. I don't like it, but.... My right hip has osteoarthritis/bone on bone also and has been hurting mostly in mornings. I plan to hold off surgery b/c as of now I can live with the right hip pain easier than the left numb/nerve area. Ortho said it was caused by my femoral nerve being retracted and causing the femoral nerve to be bruised or irritated. He said usually the nerves regenerate. The words "usually" and "should" are always the worrisome ones. I think what's it's caused is neuropathy, but I have never been to another doctor. If I do more doctoring, I may end up worse off. Good luck to all dealing with this. Joint replacements are seriously invasive surgical procedures.
Take care and hope all of us heal!!

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How are you now? I am in the same situation that you are in. I am 15 months post hip replacement surgery and I still have nerve pain around my knee and down the inside of my calf. I also had 3 mos on a walker with my leg buckling. The vice chair of orthopedic surgery at the Cleveland Clinic did the surgery and kept claiming how the surgery went perfectly. EMG test showed severe femoral nerve damage. I desperately want to get off gabapentin because of side effects but am trapped with this pain. It has slowly been lessening over the past 6 mos. PT has been great and I have worked hard at it to try to rebuild strength but the neurologist said at my age (71) to not hope for a full recovery. I’m anxious to know your progress and anything that has helped.

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Profile picture for BobbiR @bobbir

How are you now? I am in the same situation that you are in. I am 15 months post hip replacement surgery and I still have nerve pain around my knee and down the inside of my calf. I also had 3 mos on a walker with my leg buckling. The vice chair of orthopedic surgery at the Cleveland Clinic did the surgery and kept claiming how the surgery went perfectly. EMG test showed severe femoral nerve damage. I desperately want to get off gabapentin because of side effects but am trapped with this pain. It has slowly been lessening over the past 6 mos. PT has been great and I have worked hard at it to try to rebuild strength but the neurologist said at my age (71) to not hope for a full recovery. I’m anxious to know your progress and anything that has helped.

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I don't care if god himself was your surgeon. If you are enduring considerable pain the surgery did NOT go perfectly. What method was used for your surgery? Persons with the posterior method may face greater initial pain.

I am 80 and will have a TKR in a couple of days (incidentally from the same surgeon who replaced my left hip where I had zero post surgery pain). I don't anticipate any issues because of my age. I also question a neurologist who is telling you that you won't get a full recovery. Of course, if you have related other conditions, that could explain and justify his comment.

One incidental remark. Before my hip surgery I had knee pain in the leg on the same side. After my hip surgery the knee pain went away. So there can definitely be a connection betweeon the knee and nerves running down the legs.

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I had the anterior approach on the hip surgery and waited 9 mos to have it with this surgeon because of his long waiting list! I chose it because of the theoretical shorter recovery time. The neurologist said if I was in my twentys I might expect 100% recovery but not at my age - 70 at the time. I was not told that 2% of patients using anterior approach get serious nerve damage. I might have reconsidered.

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Profile picture for BobbiR @bobbir

I had the anterior approach on the hip surgery and waited 9 mos to have it with this surgeon because of his long waiting list! I chose it because of the theoretical shorter recovery time. The neurologist said if I was in my twentys I might expect 100% recovery but not at my age - 70 at the time. I was not told that 2% of patients using anterior approach get serious nerve damage. I might have reconsidered.

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Three years ago I was 77 and had a hip replacement. Zero post surgical pain and as far as I can tell, full function post replacement. I had the newer Superpath approach and my surgeon was the primary inventor of that approach.

If your neurologist is telling you that at 71 you can't expect a full recovery, I have one piece of advice for you:

FIND A NEW NEUROLOGIST!

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