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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@loriaakre

In the hospital my surgeon knew I have the numb tingling, but never touch or looked at my leg/foot just said that was normal and give it time. Next day same thing, but then said you just bought yourself another day in the hospital. He never too the wrap off or even looked at it, the nurses did it all. PT just put a leg stabler on that leg so I could stand up. I got copies of my medical records. he NEVER put any of the foot info in there. But put surgery took longer than normal because of soft tissue. asked him why, he said he puts that in all surgeries incase you need to be in the hospital longer. I had a HUGE bruise from the tourniquet that didn't notice til I got home and my husband saw it.
He never put notes in chart till months later and weren't approved until I brought it to the attention of the patient advocate at the hospital. He even hi-lighted and deleted my 3 week check up with him when I went back 3 months later and told him what he did to the artery. I took info to lawyer. They said I had a good chance for a good case of neglect. Well since he never put anything about my foot in any of his reports. In fact he had stated in my hospital report he took off the wrap and looked at my knee in the hospital. He blatantly lied on all my visits with him. I had a 2 year appoint with him for Friday 2-5-2021 and cancelled it, he is not with worth wasting my time to have him tell me again it takes time to heal the nerves and give in yet another year or two. That there was nothing he could do. NEVER once has he said I'm sorry that this had to happen, nothing! and that alone would mean a lot to me. All I was ever told was that it was normal, give it time, then why I waited 60 days to get it fixed I could of lost my leg. At one yr appointment "I suppose there will be a law suit. Well I tried since he asked, but when Doctors are allowed to lie and change their medical records you don't have a chance. Lori A.

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Wow, Lori, I would try for the lawsuit, to give you a sense of self preservation at the least. I had incredible bruising, also, from the tourniquet probably, but also I had bruises on my leg as if they grabbed it at a number of locations with strong vises, and when I came out of surgery, my foot felt like they had grabbed my foot at the ankle and rotated the foot 180 degrees and left it twisted. I have tried to get a diagnosis for my foot from a surgeon, orthopedist, PT's, podiatrist, neurologist. My chiropractor thinks it is a compressed nerve and keeps working on my spine adjustments. I am so sorry about your situation. My surgeon excused me after 6 months and said I don't need to go back for checkups. I had "sufficient" ROM but needed a lot more muscle strength the last time I saw him, and he did not care to see if I progressed from the minimal!

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@irol

Erika, don't forget to mention me. I wrote a lot about my foot neuropathy.
Lori S. (Irol)

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@irol Sorry I missed you. I try to pull people that have talked about the subject but I miss important people sometimes. Thanks for responding.

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See a neurologist immediately and have an EMG done.

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@irol

Yes, when I went to my surgeon for a followup, he would not even let me finish describing my foot problem and interrupted me, saying that it had nothing to do with the knee surgery. (It was incredibly painful and had numbness later as soon as I woke up in the recovery room). I made a special appointment to talk about the foot a few months later and he had me see the PA, not him, and she kept changing the subject and would not address any causes of the foot neuropathy as being connected to the surgery. Have you requested and read all surgery notes? Maybe you should find out how long the tourniquet was on your leg during the surgery. Over 45 minutes can cause nerve damage, I think. Maybe there were other irregularities...although they may not have recorded a problem..

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I don’t want to say it. No wants to say it. You signed a release but probably didn’t read it, nobody does, but TKRs can and do cause Complex Regional Pain Syndrome. You are presenting with the classic signs and symptoms of CRPS, whether Type I or II, you would not know without further testing and scans by a knowledgeable NEUROLOGIST.
How do I know. I had the same symptoms, foot pain and numbness, lack of control with twisting, folding, arching, unable to walk without arch collapsing and pain in foot and outside of lower leg (NOT PIRIFORMIS.)
It took 11 doctors, 2 years, and being told such things as I was “anxious, making it up,” “was exaggerating,” “a baby,” or the pain would “ go away,” was “all in my head,” “not that bad,” or my favorite, to “just suck it up.”

This is a RARE CONDITION AND NEEDS SPECIALIZED TREATMENT BY A PAIN SPECIALIST NOW. You may have a chance at remission. I didn’t.

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In response to Faithwalker007, I would like to throw out just what legal recourse any of us actually have. I was sold what I suspect was a bill of goods by my orthopedic surgeon, his assistant, and the hospital. I was recommended to have a treatment called Iovera. This entails having I think 15 injections of super cold water to essentially numb the nerves in two sites at the main nerves around the surgical site. The nerves were supposed to return to normal after a certain amount of time, but after almost two years I still have numbness at the site and incision and have had lots of neuropathy and lack of feeling all the way down to my toes. This Iovera procedure was supposed to lessen the pain during recovery. I don’t know if I have any legal grounds to sue, but I would like to.

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@irol

Wow, Lori, I would try for the lawsuit, to give you a sense of self preservation at the least. I had incredible bruising, also, from the tourniquet probably, but also I had bruises on my leg as if they grabbed it at a number of locations with strong vises, and when I came out of surgery, my foot felt like they had grabbed my foot at the ankle and rotated the foot 180 degrees and left it twisted. I have tried to get a diagnosis for my foot from a surgeon, orthopedist, PT's, podiatrist, neurologist. My chiropractor thinks it is a compressed nerve and keeps working on my spine adjustments. I am so sorry about your situation. My surgeon excused me after 6 months and said I don't need to go back for checkups. I had "sufficient" ROM but needed a lot more muscle strength the last time I saw him, and he did not care to see if I progressed from the minimal!

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I did ck w a lawyer and they said I had a really good case for neglect because the surgeon did nothing to ck into why my foot/leg was totally asleep. Even at my 3week he said it was normal even though my toes were purple and my foot was cold. I got my medical records which were sent to a medical expert only to find out he had nothing in my notes from all my visits that said my foot had any problems and in the hospital notes said he unwrapped my leg to look at incision. He never came within 5 feet of the end of the bed on the 3rd & 4th morning. Nurses took off wrap and put bandage on before I left for home. So the lawyers wound not take the case because there would be no way I would win and between the knee and artery surgery I had over $250,000 and if I would of won insurance gets paid back first, lawyers wanted 40% and $325 and hour. And if lost I’d have to pay $325 per hour and any specialist brought in and more than likely any incurred cost on the other side. It sounded like a lose lose case. So I dropped it. But not forgotten.

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@faithwalker007

I don’t want to say it. No wants to say it. You signed a release but probably didn’t read it, nobody does, but TKRs can and do cause Complex Regional Pain Syndrome. You are presenting with the classic signs and symptoms of CRPS, whether Type I or II, you would not know without further testing and scans by a knowledgeable NEUROLOGIST.
How do I know. I had the same symptoms, foot pain and numbness, lack of control with twisting, folding, arching, unable to walk without arch collapsing and pain in foot and outside of lower leg (NOT PIRIFORMIS.)
It took 11 doctors, 2 years, and being told such things as I was “anxious, making it up,” “was exaggerating,” “a baby,” or the pain would “ go away,” was “all in my head,” “not that bad,” or my favorite, to “just suck it up.”

This is a RARE CONDITION AND NEEDS SPECIALIZED TREATMENT BY A PAIN SPECIALIST NOW. You may have a chance at remission. I didn’t.

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@faithwalker007 I had totally asleep foot that was numb and tingly so bad it hurt. Couldn’t put weight on it without it buckling. They put leg stabilizer on so I could stand up. It was my primary dr. that said it wasn’t normal and ordered some tests. It was an ABI ultrasound that found I had little to no pressure in that leg and an angiogram following that found the pinched artery behind my knee which was done during my total knee replacement. Had surgery to take the clot out but it was almost 60 days later so I have cell, tissue and nerve damage and still have numb tingly issues on the bottom of my foot and outside of the calf numbness. I went through nerve tests as well. I was fortunate to have mobility of the foot and did well in all the PT I had.

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I had a right total knee replacement in Sept. 2019 and also came out of surgery with numbness and tingling/pain on my right foot. It is now17 months later and I still have it. I just went to a neurologist to see if we can figure the cause for sure. She already seems to think my back is the problem rather than nerve damage but, that remains to be seen. My Orthopedic surgeon also told me that the neuropathy would likely be gone within a year. That didn't happen for me. Trying to find further information on the web when I saw your comment.

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@tigger2648

I had a right total knee replacement in Sept. 2019 and also came out of surgery with numbness and tingling/pain on my right foot. It is now17 months later and I still have it. I just went to a neurologist to see if we can figure the cause for sure. She already seems to think my back is the problem rather than nerve damage but, that remains to be seen. My Orthopedic surgeon also told me that the neuropathy would likely be gone within a year. That didn't happen for me. Trying to find further information on the web when I saw your comment.

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I’m glad you are visiting a neurologist. You also need a PT that knows about mirror therapy. Because I believe no matter the cause or if they can’t find a cause, it would help you immensely. But it needs to be started now.

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@tigger2648

I had a right total knee replacement in Sept. 2019 and also came out of surgery with numbness and tingling/pain on my right foot. It is now17 months later and I still have it. I just went to a neurologist to see if we can figure the cause for sure. She already seems to think my back is the problem rather than nerve damage but, that remains to be seen. My Orthopedic surgeon also told me that the neuropathy would likely be gone within a year. That didn't happen for me. Trying to find further information on the web when I saw your comment.

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Got the same line from my surgeon, it's a back thing, it's not his doing!, and it will go away, 13 months later it's exactly still the same. Funny it came the same day I had TKR. What else can you expect? them admitting to screwing you over for life? Note: Hard to find a doctor to say a bad word against another. My neurologist would not either.

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