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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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Amanda Roe | @amandajro | Nov 21, 2020

Hello @mslorenzo and welcome to Mayo Clinic Connect. I understand you are still experiencing tingling, numbness and burning following your TKR and are looking to connect with others who have had similar experiences like @navyqas @irol @monana and @may2383.

Did you surgeon discuss these symptoms as possible post-surgical outcomes and does he/she know of your current complications?

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denver | @denver | Nov 21, 2020
In reply to @janedahlgren "Hello, I had R TKA July 28th. Immediately after surgery noticed foot numbness and foot drop...." + (show)
@janedahlgren

Hello, I had R TKA July 28th. Immediately after surgery noticed foot numbness and foot drop. Surgeon ordered foot brace to wear so I didnt trip and fall over R foot. Initially nurses and surgeon said oh just need to wait for block to wear off. May retake 2 days, may take 2 wks. As of today there has been no change. Surgeon finally ordered MRI, EMG, NCS all to look for nerve damage. MRI did not pick it up but the other tests did. Surgeon finally admitted there was nerve damage. Today I will see the neurologist for her take on all this after she reviews all tests and looks at me. Lower leg and foot are very stiff. Atrophy of muscles setting in because damaged peroneal nerve cant communicate with leg muscles. Have been told it may take a year for nerve to heal but I've seen NO change in 3.5 months so hard for me to believe there will be any improvement. Nerve was damaged behind my knee. Hurts to rest knee on chair like when you sit and on seat of car to drive. Leg feels heavy cuz upper leg muscles need to do all the work to lift lower leg like when going up stairs or moving foot from gas to brake in car. Anyway, will see how neurologist sums things up today. Hope this was helpful. May be looking at litigation sooner than later...

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I am so sorry to hear of your poor outcome and pain. I hope you find a way for relief. How awful for you.

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denver | @denver | Nov 21, 2020
In reply to @irol "I wish we could get surgeons to inform patients of possible foot numbness and nerve danage..." + (show)
@irol

I wish we could get surgeons to inform patients of possible foot numbness and nerve danage as one of the tkr side effects. My surgeon denied any connection when I tried to tell him about my symptoms. When I came out of surgery my toes were totally numb. It turns out I had some damage to the peritoneal nerve and the numbness kept decreasing as I became more active. I am a year and half out from surgery. I try to be consistently be conscious of moving my toes up and down and flexing my toes as much as possible during the days. I broke my foot when I was at a year into recovery and had to start all over again after immobilizing the foot for months while the bone healed. It seems like the key is to keep movement in the foot as much as possible. February will be two years out from surgery and it is pretty minimal now.

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I agree, they don't do enough pre op teaching or testing. Maybe we can get things to change for the health of future patients.

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loriaakre | @loriaakre | Nov 21, 2020
In reply to @monana "Thank you for responding. I'm sort of hopeful that at least it might get better. No..." + (show)
@monana

Thank you for responding. I'm sort of hopeful that at least it might get better. No I certainly did not expect this. I will keep working on it and pray that it will improve.

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ask for and ABI test. it is like a blood pressure test for the legs. that is how they figured out that my popliteal artery was pinched behind my knee and I need yet another surgery to fix the artery. My foot is still numbish feeling but at least my toes are no longer purple. my TKR surgeon ask me why I waited 60 days to get it fixed...you could of lost your leg. HE DID NOT LISTEN TO ME! I told him right after surgery and the next 3 following days and at my 2 week check up. my primary was the one who ordered the ABI test. I told several ortho drs. that it was not normal my other knee wasn't like that. Good Luck!

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irol | @irol | Nov 22, 2020
In reply to @mslorenzo "I had a total knee replacement 7 weeks ago and have tingling,numbness and burning in my..." + (show)
@mslorenzo

I had a total knee replacement 7 weeks ago and have tingling,numbness and burning in my foot ever since the surgery. I was wondering if your pain has subsided and if so how long did it take?

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Mslorenzo-It took me a year!
Lori

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navyqas | @navyqas | Nov 22, 2020
In reply to @mslorenzo "I had a total knee replacement 7 weeks ago and have tingling,numbness and burning in my..." + (show)
@mslorenzo

I had a total knee replacement 7 weeks ago and have tingling,numbness and burning in my foot ever since the surgery. I was wondering if your pain has subsided and if so how long did it take?

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8 moths after TKR:
If I remember correctly, I had pain (very bad) for like two months in the knee area after TKR (leg was black and blue from groin to foot), the numb feeling on the bottom of the foot (mostly heel area) is still about as bad as it was from day one (the foot burning is gone). I have learned to live with not feeling my heel and some slight numbness other then the heel area. I am a pessimist for the most part, BUT for some reason I believe time will fix the foot situation as it is not getting worse (I monitor it very closely), I can hike and bike with the foot, the knee came out good, and that's a Biggy! PS picture is from several days after TKR, guess I won't be a leg model.
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suewilliamaon | @suewilliamaon | Nov 22, 2020

This sounds exactly the same as my situation. Now 11 weeks post TKR. The ankle and foot are a big problem. It feels as there is a big strap around my ankle, going underneath my foot and around big toe, it seems to get tighter at night and also causes numbness in lower leg and calf. Sleeping is an issue. Positive I have no pain in my knee and that seems to be doing well. Trying to stay positive. My surgeon has put me up for a ct scan. I would welcome any techniques to help deal with the situation!

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janedahlgren | @janedahlgren | Nov 22, 2020

Get a neurologist to do electromyography, nerve conduction study and mri to find where peroneal nerve was damaged during surgery!!!!!The surgeon should order these tests!

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1 reply
josie1957 | @josie1957 | Nov 22, 2020

I had a total knee replacement, on August 27th it will be 2 years. Ever since i woke up in recovery i have had neuropathy in my right foot, from my ankle to my toes and on top of toes. I don't think it will ever go away. I was an UBER driver but since i cant feel my right foot, the doctors says no driving.

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navyqas | @navyqas | Nov 22, 2020
In reply to @janedahlgren "Get a neurologist to do electromyography, nerve conduction study and mri to find where peroneal nerve..." + (show)
@janedahlgren

Get a neurologist to do electromyography, nerve conduction study and mri to find where peroneal nerve was damaged during surgery!!!!!The surgeon should order these tests!

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I asked one of the top neurologist in NJ before testing if he would operate to correct MY numbness, he said no, so what's the sense I said, he agreed.

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