Had anyone had nerve ablation for post op TKR pain?

Posted by irishtrish @irishtrish, Sep 30 6:44am

My pain management doctor is recommending a nerve ablation to temporarily (6+ months) deaden the nerves around the implant. As I can't take NSAIDS (ibuprofen) due to renal cell carcinoma, my OTC options are limited for pain and swelling (Tylenol does nothing). Does anyone have experience with this procedure and would you recommend it?

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Profile picture for steveinarizona @steveinarizona

@lynnn

The definition of unsuccessful mostly includes people who are not satisfied with the feeling of the implant or the mechanics of it compared to their expectations.

I was severely misaligned and bone on bone. My surgeon did discuss with me doing a partial but he determined that my arthritis was too bad on all surfaces. So he did a total which even included doing a patelloplasty. I wanted a bicruciate retaining implant if my ACL was strong enough and my surgeon who is vastly experienced doing that agreed. it turned out that despite my "severe fixed contracture and valgus" he was able to both do a BCR (Journey II XR) and fix my alignment with a functional alignment.

I came out of it with only pain when I first stood up and started walking (with a walker as my surgeon insisted that I use one my first week) and some soreness around the muscles above the knee. After about 20 feet the pain from my incision area mostly abated.

So...it is possible to have a TKR, even a complex one, without substantial pain. Most of it depends upon finding and using an incredibly skilled surgeon (great mind, great hands) but some of it does depend upon pure luck. Feces does sometimes just happen.

I have stenosis in my spine. For years it was non symptomatic. Then at the beginning of 2025 it became symptomatic with pain radiating down my legs. My pain doctor gave me a steroid shot (caudal, epidural) and my pain is in abeyance (right now). On the other hand, I had severe paid on my right leg (my surgical leg) when I stepped the wrong way on my heel. A nerve impingement from the knee I determined (with the help of my pain doctor, my knee surgeon, and my foot/ankle surgeon). My surgeon gave me a steroid shot in the knee and it did nothing. But after my knee surgeon replaced my knee and did the functional alignment, the pain disappeared (12 days ago).

My only thought would be to see a good neurosurgeon. When my Neurologist first sent me to a neurosurgeon for an opinion, the neurosurgeon put me on what he termed a watchful waiting list of about a hundred patients. He is/was top rated and very busy doing minimally invasive surgeries (he wrote the primer on it) so he has no need to rush people into surgery. Look for a neurosurgeon like that and see if you can get an appointment. No one understands nerves like a good neurosurgeon.

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@steveinarizona Thank you. I have not been able to find a definition of unsuccesssful re knee surgery, so I would assume something doesn’t feel or work right. After I wrote, the night pain has greatly diminished. I had a great surgeon and all well with xray. Seems it was nerve regeneration for a long time. However, I am now having night pain in the other knee, so here I go again.
So sorry you had so much difficulty but glad you have a good outcome.

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Don't automatically assume it is your knee. It could be a form of neuropathy, restless leg syndrome, or other causes. Make sure you get it properly diagnosed before you jump into knee replacement surgery.

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Profile picture for lynnn @lynnn

I read on several sources that around 750,00 TKR’s are done yearly in the U.S.
Success was mentioned as 85-90%. So even at a generous 90%, that means about 10% (75,000) are not successful. But I haven’t read criteria used to
determine that. I am at ten months with daytime comfort, but night pain
preventing much sleep. I hope this is not predictive. And I do daily exercises.

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@lynnn
My knee surgery gave me so many problems. After about three years and two surgery I am in more pain than before surgery. Went to HSSS TOP hospital of the country. But had a negligent greedy Dr who did not take medicare. Paid cash. Once your surgeries are messed up. Other surgeons do not want to touch you. Lost faith in American medical system.

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Profile picture for healthtalk @healthtalk

@lynnn
My knee surgery gave me so many problems. After about three years and two surgery I am in more pain than before surgery. Went to HSSS TOP hospital of the country. But had a negligent greedy Dr who did not take medicare. Paid cash. Once your surgeries are messed up. Other surgeons do not want to touch you. Lost faith in American medical system.

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@healthtalk So sorry you had all this problem. You must feel betrayed after paying cash for this. Since my last writing I am now having day pain and burning and night pain again. I thought I was improving. My GP gave me a prescription for nerve pain. I hope that is the problem. I am at 10 months. I hope you have some improvement. Terrible to have these difficulties.

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Profile picture for healthtalk @healthtalk

@lynnn
My knee surgery gave me so many problems. After about three years and two surgery I am in more pain than before surgery. Went to HSSS TOP hospital of the country. But had a negligent greedy Dr who did not take medicare. Paid cash. Once your surgeries are messed up. Other surgeons do not want to touch you. Lost faith in American medical system.

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@healthtalk I was there yesterday and even though they don’t take your insurance, you still give them whatever insurance you got and the bill will be a lot less. It’s out of network service.

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I paid Dr fee 16000 cash. Insurance covered rest. But Dr Gets greedy and squeezed few more surgeries on the same day. I was asked to come at noon but my my surgery did not start till 8.30pm. This is our HSS - best hospital of USA

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