Had anyone had nerve ablation for post op TKR pain?

@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.

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.

@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.

@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.

Yes, Ive had several knee ablations post-TKR. They are painful but you can drive after. I have to admit that they only helped me with about 30% of my pain for a couple of months- no where close to 6 months. After 4 per knee I have taken a break to see if I notice a big difference. They dont help with the tightness I have (24/7) . They help a bit with the sharp pain I have when walking. Not sure yet if I will try again.

@andid Not exactly a ringing endorsement. I think I’ll pass. 4 per knee sounds like a gracious plenty. Why do you keep going back?

I have not had an ablation before TKR so I really cant answer your question. I went right from HLA to Synvisc to replacement. I think the thing to be wary of is talking your surgeons into anything. In my experience this is their profession. Its what they do. if they think you need it, get on a list and, even then, think twice. A certain percentage of TKRs fail. Mine are painful every day. No quality of life. Sure I can bend them but I still cant walk for more than a block or two without sharp pain.

@andid

Surgeons like to cut, it is why they became surgeons. Find a surgeon with a significant waiting list so she has no financial incentive to cut you.

I do somewhat disagree with @andid regarding timing. Many who get TKRs suffer severe pain but others (such as me) don't suffer at all. One can take steps to maximize one's chances of being pain free or pain minimized. I was prepared for pain post surgery because I had been having pain, some severe, for nine months. So recovery pain was a doable and sufferable alternative but I did research to find an experienced surgeon who could do a subvastus or midvastus approach and do a Functional Alignment to take care of my severe valgus misalignment.

The relief from ongoing pain is incredible. But I have to admit that I am one of the outliers who had no post surgery pain. Would it have been worthwhile if I was an outlier on the other end of the scale? I think so but it is easy for me to say that.