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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@drbaisley

I had a 2nd total Knee replacement on May 10th 2021 due to the first replacement failing. On May 16 my foot began to swell and bruising appeared the following morning( see photos). Ever since my ankle and my foot have become an Issue with walking and doing my physical therapy. Its extremely painful and at nights I am unable to sleep due to so much pain. I elevate the foot 8 inches above my heart but the pain is a 9 or ten on the scale. I have been screaming out at night that I have to go to the emergency room due to the amount of pain IM experiencing. The following mornings the swelling subsides so i feel ok but as the day progresses the swelling returns and its back to extreme pain at night. today is four weeks since my replacement.

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Hello @drbaisley, Welcome to Connect, I'm sorry to hear about the foot swelling and pain after your knee replacement. I had my right knee replaced 2 years ago but have not experienced pain in the foot area like you have. I did find some information that seems to describe your symptoms after a total knee replacement.

A rare complication of total knee arthroplasty: Type l complex regional pain syndrome of the foot and ankle: https://www.sciencedirect.com/science/article/pii/S1017995X16301237

Have you discussed the pain and swelling of your foot with your surgeon or care team?

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@drbaisley

I had a 2nd total Knee replacement on May 10th 2021 due to the first replacement failing. On May 16 my foot began to swell and bruising appeared the following morning( see photos). Ever since my ankle and my foot have become an Issue with walking and doing my physical therapy. Its extremely painful and at nights I am unable to sleep due to so much pain. I elevate the foot 8 inches above my heart but the pain is a 9 or ten on the scale. I have been screaming out at night that I have to go to the emergency room due to the amount of pain IM experiencing. The following mornings the swelling subsides so i feel ok but as the day progresses the swelling returns and its back to extreme pain at night. today is four weeks since my replacement.

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More people need to know what damage they can do, I did not. 14 months with a numb foot, if anything it got worse, They will tell you it takes lots of time to get better, I do not believe them any longer. Life sentence numbness because why? sloppy work?

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@navyqas

More people need to know what damage they can do, I did not. 14 months with a numb foot, if anything it got worse, They will tell you it takes lots of time to get better, I do not believe them any longer. Life sentence numbness because why? sloppy work?

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today im four weeks out from my surgery. I also had extreme bruising all of my leg as well as you can see my left foot. I respect my doctor and know him very well. He is amazing and one of the best in southern Calif. Yes there are some doctors that i would not send my worse enemy too. Once you start going to physical therapy i do hope you will see a big difference. Yes I am still on a walker and still weak on my leg. remember this is a replacement for a TKA i had prior, so this is my 2nd knee replacement. I also told my doctor that prior to this TKA surgery I had flair ups & bouts of arthritis and I would take Celebrex for the pain. Celebrex works wonders for arthritis.

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@drbaisley

today im four weeks out from my surgery. I also had extreme bruising all of my leg as well as you can see my left foot. I respect my doctor and know him very well. He is amazing and one of the best in southern Calif. Yes there are some doctors that i would not send my worse enemy too. Once you start going to physical therapy i do hope you will see a big difference. Yes I am still on a walker and still weak on my leg. remember this is a replacement for a TKA i had prior, so this is my 2nd knee replacement. I also told my doctor that prior to this TKA surgery I had flair ups & bouts of arthritis and I would take Celebrex for the pain. Celebrex works wonders for arthritis.

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The doctor I went to for surgery is one of the best in NJ, has more stars for reviews then the sky, was referred to me by close friends in the financing of medical businesses, my point being, his references could not have been better. BUT, because they juggle multiple operations at the same time and do soooo many, I believe they get cocky and sloppy, they screw up. I will live with a numb foot for the rest of my life, had I known I would not have let him touch me. As a quality assurance specialist for 42 years I am a good judge of work/people, my surgeon seemed over confident (big head), and that may have contributed to the nerve damage. I never knew a TKR was supposed to be a gamble.

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@navyqas

The doctor I went to for surgery is one of the best in NJ, has more stars for reviews then the sky, was referred to me by close friends in the financing of medical businesses, my point being, his references could not have been better. BUT, because they juggle multiple operations at the same time and do soooo many, I believe they get cocky and sloppy, they screw up. I will live with a numb foot for the rest of my life, had I known I would not have let him touch me. As a quality assurance specialist for 42 years I am a good judge of work/people, my surgeon seemed over confident (big head), and that may have contributed to the nerve damage. I never knew a TKR was supposed to be a gamble.

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I dislocated my knee 20 years ago and it caused nerve damage that caused foot drop, so after a year living with 2 braces they did a foot lift with a tendon transfer, my surgeon took a tendon that made my foot go side to side and placed it so it moved up and down, therefore allowing me to walk without a foot brace or tripping over my foot that hung down.
It was very successful to the surprise and delight of my surgeon, come to find out it was the first he had preformed!
He had been an orthopedic surgeon for 25 years and had all the great reviews and accolades!, my point is I’m glad it worked but I would of been more apprehensive had I known it was his first.
I still have some of the nerve damage and it’s my worse knee now that I’m older..
but I do think the nerve has slowly gotten better over the years. I hope you regain at least some nerve healing, but it does take time.
I am very hesitant to even have steroid injections in my knee because I don’t want any more nerve damage, same with knee replacement too.
Good luck to you!

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Nerves are often damaged, or at least "insulted" in the course of orthopedic surgery, and need to heal or regenerate. This is not necessarily permanent neuropathy, simply part of the healing process. Injured nerves must first heal, and if actually cut or torn, then regenerate. It is an excruciatingly slow process. One surgeon explained, when I was younger and far more impatient that it can take a year for one inch of nerve to regenerate - the current science seems to indicate about 1mm per day of healing.

After one ACL/MCL knee surgery and 5 hip replacement surgeries, as well as several surgeries on hands and fingers, I have experienced numbness and tingling more times than not. As I write this, my daughter is healing from a traumatic and complicated wrist fracture and subsequent surgery, and yesterday, she began experiencing the sensations and I was able to calm her by telling her my experience. My sister in law had about a year of the tingling and "electric shock" sensations interspersed with numbness after on knee replacement, virtually nothing on the other - with the same procedure and surgeon. Now, after 2+ years the leg is fine.

Here is what Mayo Clinic has to say about nerve injuries: https://www.mayoclinic.org/diseases-conditions/peripheral-nerve-injuries/diagnosis-treatment/drc-20355632

Good luck with your healing
Sue

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@rebeccakay

I dislocated my knee 20 years ago and it caused nerve damage that caused foot drop, so after a year living with 2 braces they did a foot lift with a tendon transfer, my surgeon took a tendon that made my foot go side to side and placed it so it moved up and down, therefore allowing me to walk without a foot brace or tripping over my foot that hung down.
It was very successful to the surprise and delight of my surgeon, come to find out it was the first he had preformed!
He had been an orthopedic surgeon for 25 years and had all the great reviews and accolades!, my point is I’m glad it worked but I would of been more apprehensive had I known it was his first.
I still have some of the nerve damage and it’s my worse knee now that I’m older..
but I do think the nerve has slowly gotten better over the years. I hope you regain at least some nerve healing, but it does take time.
I am very hesitant to even have steroid injections in my knee because I don’t want any more nerve damage, same with knee replacement too.
Good luck to you!

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So very few if any good endings, I am very happy for you, I have developed terrible low back pain 8 months after TKR, it may not have anything to do with the TKR but timing is ironic. MRI says disks L4 & L5 problem, went to a neurosurgeon and he may perform surgery if pain specialist doctor can not correct, point being: I would NOT trust a orthopedic surgeon anywhere near a nerve if I could help it, also note, I am 74 and WAS in perfect health (except knee) prior to knee replacement, never so much as took an aspirin, now I am shot and not good for much with this back. I did try the knee gel shots prior to knee replacement, $1400 for the 3 shots and saw no difference then I got the TKR.

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@navyqas

So very few if any good endings, I am very happy for you, I have developed terrible low back pain 8 months after TKR, it may not have anything to do with the TKR but timing is ironic. MRI says disks L4 & L5 problem, went to a neurosurgeon and he may perform surgery if pain specialist doctor can not correct, point being: I would NOT trust a orthopedic surgeon anywhere near a nerve if I could help it, also note, I am 74 and WAS in perfect health (except knee) prior to knee replacement, never so much as took an aspirin, now I am shot and not good for much with this back. I did try the knee gel shots prior to knee replacement, $1400 for the 3 shots and saw no difference then I got the TKR.

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Before giving up, you might want to consider PT with a therapist who specializes in joint rehab and pain management.

I had serious back pain after hip replacement, deteriorating disks, spinal stenosis, etc. First ortho sent me to a "Back Clinic" where they used a standard, one-size-fits-all program; they put me in torture machines and all got worse.

But, according to my second ortho, may people with arthritis have spine issues and can live well. He suspected I had gait problems from years of limping on bad hips. Sent me to a rehab clinic that studied my body, posture, gait and got me onto an individual program of land and water therapy with stretching and exercise - voila! I was able to live with the back issues.

Fast-forward 8 years, other health issues, more arthritis, more pain - a pain doc sent me again for targeted PT with a guy who creates individual programs and does myofascial release (MFR) - again lowered the pain to a manageable point. I still do most of the exercises he designed for me 3-5 times a week. One year later, I am able to do more than for the past 5-6 years.

Part of the answer is being your own best advocate. Learn everything you can about your situations and possible non-invasive treatments. Find what works for you and do it. Remember, you have to live in your body, the doc only has to look at it for a few minutes and then you go away. Who is more motivated to find the solution?
Sue

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@navyqas

So very few if any good endings, I am very happy for you, I have developed terrible low back pain 8 months after TKR, it may not have anything to do with the TKR but timing is ironic. MRI says disks L4 & L5 problem, went to a neurosurgeon and he may perform surgery if pain specialist doctor can not correct, point being: I would NOT trust a orthopedic surgeon anywhere near a nerve if I could help it, also note, I am 74 and WAS in perfect health (except knee) prior to knee replacement, never so much as took an aspirin, now I am shot and not good for much with this back. I did try the knee gel shots prior to knee replacement, $1400 for the 3 shots and saw no difference then I got the TKR.

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So sorry your having more trouble after TKR, I hope you can get some relief to your back.
I am like you never took any meds even over the counter but have been taking a small amount of Motrin for my knees and I pulled a muscle in my hip gardening. They offer muscle relaxers but I’m trying not to use unless necessary!
I am 59 and I the knee injury at 31. Boy time flys quickly!
Good luck, I hope for good results for you!

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@navyqas

So very few if any good endings, I am very happy for you, I have developed terrible low back pain 8 months after TKR, it may not have anything to do with the TKR but timing is ironic. MRI says disks L4 & L5 problem, went to a neurosurgeon and he may perform surgery if pain specialist doctor can not correct, point being: I would NOT trust a orthopedic surgeon anywhere near a nerve if I could help it, also note, I am 74 and WAS in perfect health (except knee) prior to knee replacement, never so much as took an aspirin, now I am shot and not good for much with this back. I did try the knee gel shots prior to knee replacement, $1400 for the 3 shots and saw no difference then I got the TKR.

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Same here. I had a partial knee replacement and it was never right. The doctor keeps saying it is ok, buy now I have Neuropathy and the knee is very painful. I am getting worse too. Pain in both legs now, and numbness in my arms and face. Also I developed Tinnitus. I am so sorry I had this surgery. It's been over 4 years now.

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