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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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melcpa86 | @melcpa86 | Nov 28, 2019

I have been unable to stand for more than 10 minutes or walk for more than 30 without pain since my replacement in March of 2018. I’m 55. I was recently diagnosed with an “extra bone in my foot” that was traumatized during the events of the surgery as well as the “alignment of my knee and ankle being a hare off”. Supposedly, the combination of these two things is causing my pain- so I’m now considering surgery #3 related to this knee. The surgery won’t fix the mailalignment - supposedly will eliminate a lot of the standing / walking pain to where custom orthotics can then realign the knee and ankle.

Just in case this helps anyone else....
The bone is called an assessory navicular. About 10% of the population have it. A foot xray and foot MRI bot show it. It caused pain in your inside of your ankle and along your posterior tibial tendon if severely traumatized.

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2catfamily | @2catfamily | Dec 9, 2019
In reply to @loriaakre "Ask for an ABI that looks for blood flow below the knee. They found that was..." + (show)
@loriaakre

Ask for an ABI that looks for blood flow below the knee. They found that was my prob with my numb tingly foot

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What kind of doctor do you ask for a ABI ?

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willieblack | @willieblack | Dec 30, 2019
In reply to @contentandwell "@gator1965 You have been issued with a "formal written warning"? Is that from your medical team..." + (show)
@contentandwell

@gator1965 You have been issued with a "formal written warning"? Is that from your medical team or your work? If from work I presume it must be that if you do not get back to work you will be terminated. I'm sorry if that is the case, and I hope you can manage to keep up with your job despite the pain.
My doctor is doing a small procedure on me, probably next month, to go in and get rid of some of the adhesions that prevent me from having better flex. It's called "arthroscopic lysis of adhesions". Does that sound like something that could help you? The procedure was described as follows by the doctor's NP -- "goes in with a small camera and a small tool that burns the scar tissue away". This is an outpatient procedure and you can immediately put your weight on the leg. The incisions are only about a half inch long.
I do not have pain, just poor range of motion. He said I could never get along in Japan with my lack of flexion. I do get along here, but it is difficult to do certain things so I hope I will gain a bit more flex from the procedure.
I hope your doctor, or another if you get a second opinion, can give you some help.
JK

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I had that procedure done two years after my tkr. It helped for about 6-8 months afterward. Presently I’m experiencing patella pain and constant swelling. Had a bone scan done which confirms the area is “active”. Presently I’m seeking a third opinion. The 1st mentioned a revision. The 2nd was hesitant to suggest revision due to the mechanical parts are solid. But offered no definitive details to my patella issue other that possible scar tissue under the knee cap.

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imlmcooper | @imlmcooper | Dec 31, 2019
In reply to @contentandwell "@gator1965 If your pain has been going on for that long I would definitely get a..." + (show)
@contentandwell

@gator1965 If your pain has been going on for that long I would definitely get a second opinion from the best possible orthopedic surgeon you can find.
I have had two knee replacements and never experienced anything like that. There are a couple of private groups on Facebook that are just for people with knee replacements. That can be a good source of information also because most of the people who are part of the group are there due to problems. It can't hurt to check as many resources as you can find. There really is no monitoring of those groups though as there is on Mayo Connect.
I hope you can find some answers and are able to get some help in alleviating the pain. As I said up top, the first thing I would do is get a second opinion.
JK

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I had both knees replaced..2012 and 2014. I have been diagnosed with peripheral neuropathy. My foot pain is mostly in the bottom of my feet and can be excruciating. I have severe leg pain from my knees down and my legs feel cold. I have always wondered if there is a connection to my knee surgery because I had none of these problems before.

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1 reply
willieblack | @willieblack | Jan 1, 2020
In reply to @contentandwell "@gator1965 That's a lot of pressure to be under. Your flexion is still not optimal of..." + (show)
@contentandwell

@gator1965 That's a lot of pressure to be under.
Your flexion is still not optimal of course, they generally want it to be at least 120°. I think mine is at around 112° now, but as I said, I do not have any discomfort. The other knee that was done about 6 years ago has slightly better flex but when I do much walking that one does hurt. I used a different surgeon and got a different knee for that one.
Does your doctor have any idea what is causing the discomfort? I would want to know that. I had a friend who went two years with pain before she found a highly rated orthopedic surgeon, and he found the problem and fixed it. I hope you will find a surgeon who can do the same for you.
JK

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What was the detailed result/outcome of your friend?

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JK | @contentandwell | Jan 3, 2020
In reply to @imlmcooper "I had both knees replaced..2012 and 2014. I have been diagnosed with peripheral neuropathy. My foot..." + (show)
@imlmcooper

I had both knees replaced..2012 and 2014. I have been diagnosed with peripheral neuropathy. My foot pain is mostly in the bottom of my feet and can be excruciating. I have severe leg pain from my knees down and my legs feel cold. I have always wondered if there is a connection to my knee surgery because I had none of these problems before.

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@imlmcooper Did the problem start in one leg after the first TKR and in the second leg two years later? That of course would be a huge red flag. I never had those problems after either of my TKRs and they were done by different doctors.

@willieblack My friend now is able to walk without a lot of pain. She is not a very close friend so I can't give you details, but she is extremely active and always on the go so I have to assume she is doing well. She gave a huge amount of credit to the surgeon in Boston who corrected her problem. The problem was that the rod or something like that, was too long for her leg! She is about to have a shoulder replacement now. I hear those are pretty painful.

Also, since the reply you referred to, I had my yearly appointment with my orthopedic surgeon. My flex is not as bad as I thought it might be, it's just under 120. Everything looked good on the Xrays. Now I don't have to go back for three years.
JK

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clmeritt1962 | @clmeritt1962 | Jan 4, 2020

I have the same issue. It is driving me crazy! I dont have pain. I have full function of my foot.

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tjh708 | @tjh708 | Jan 4, 2020
In reply to @clmeritt1962 "I have the same issue. It is driving me crazy! I dont have pain. I have..." + (show)
@clmeritt1962

I have the same issue. It is driving me crazy! I dont have pain. I have full function of my foot.

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How long ago was your surgery? I’m now at 5 moths after surgery and the numbness in the bottom of my foot is pretty much the same as when I awoke from surgery.

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1 reply
sfcob | @sfcob | Jan 5, 2020

Had a TKR 5years ago and a revision in Oct 2019. After my TKR 5 years ago my foot was numb. My Orthopedic said to give it time. I have had to EMG’s done, both show no nerve damage, seen pidoitry and they have no solution, and I have seen neurology, who told me to buy shoes that are comfortable. My foot is always numb and the only shoe I can wear that doesn’t make it worse are my sandals, which i can’t do in the winter. No DR can explain what has happen as I have good strength in my foot and leg. Has anyone else experienced this? All the Dr’s want to do is put me on gabapentin and not figure out what is wrong.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jan 5, 2020
In reply to @sfcob "Had a TKR 5years ago and a revision in Oct 2019. After my TKR 5 years..." + (show)
@sfcob

Had a TKR 5years ago and a revision in Oct 2019. After my TKR 5 years ago my foot was numb. My Orthopedic said to give it time. I have had to EMG’s done, both show no nerve damage, seen pidoitry and they have no solution, and I have seen neurology, who told me to buy shoes that are comfortable. My foot is always numb and the only shoe I can wear that doesn’t make it worse are my sandals, which i can’t do in the winter. No DR can explain what has happen as I have good strength in my foot and leg. Has anyone else experienced this? All the Dr’s want to do is put me on gabapentin and not figure out what is wrong.

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Hi @sfcob, welcome to Connect. I moved your post to this existing discussion about numbness, tingling, pain and other neuropathic symptoms following a total knee replacement. Click VIEW & REPLY to see the entire discussion.

You might also be interested in this discussion with @wendim @irol @2catfamily
> Joint Replacements > TKR and problems with foot tingling and pain https://connect.mayoclinic.org/discussion/foot-tingling-and-pain/

Sfcob, is the numbness you are experiencing only in the leg that you had the knee replacement?

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