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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@sueinmn

You may need to see a different ortho, or see a neurologist or cardiologist to determine why this is continuing so long. You can get a referral from your PCP.
Sue

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I have an excellent cardiologist. My pcp is not the sharpest pencil in the box. I am just not a 'doctor' person, nor a pill popper. I think the doctor/s who did the knee replacement knew what they did to cause this, and refused to be truthful, so they pushed pills and lied. I lack trust in doctors after that. I went to a premier medical group in the Midwest for the replacement and expected more skill, and truthful concern...NOT having to seek the assistance of a bunch of other doctors. Thanks for your views.

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@ljn

I have an excellent cardiologist. My pcp is not the sharpest pencil in the box. I am just not a 'doctor' person, nor a pill popper. I think the doctor/s who did the knee replacement knew what they did to cause this, and refused to be truthful, so they pushed pills and lied. I lack trust in doctors after that. I went to a premier medical group in the Midwest for the replacement and expected more skill, and truthful concern...NOT having to seek the assistance of a bunch of other doctors. Thanks for your views.

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Hi ljn-I've experienced nerve involvement in both of my knee replacements and gabapentin was prescribed to settle that down. The nerves from my LTKR have since healed and I've just started experiencing nerve zingers after my very recent RTKR. I hope you're able to find answers and relief soon. It's a maddening sensation for sure Good luck!

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I also have arthrofibrosis after TKR. The left knee replacement was done October 6, 2020. I had arthroscopic surgery May 5, 2021 by the same surgeon to remove scar tissue. He said he 'roto-rooted around the patella" to remove a lot of scar tissue. He said it's not a common surgery but he's done a few. He said he'd never seen the scar tissue reform but it has in my case.

But to the point of this thread I also have tingling and pain in the left foot since the surgery. Nothing seems to affect it, but I don't take anything for it.

I'm hesitant to inform the surgeon about recurrence of the scar tissue since I do not want a third surgery.

Not sure this is neuropathy.

I can bend the knee to about 100 degrees, after outpatient physical therapy since last October two or three times a week supplemented by home PT when I can, two or three times a week.

I'm sort of resigned to the status quo being permanent. Should I be?

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@ljn

I see that gabapentin was prescribed for knee replacement patients who seem to present with nerve damage pain. My surgeon prescribe gabapentin from day one after surgery. But he did not prescribe this drug for any other of his knee replacement patients that I know. So I asked him why...and he said for pain. When I wanted to have the conversation about nerve involvement he refused. I did and three years later still do suffer nerve pain in my leg and ankle. The surgeon told me it was my heart. It was not. I sure could use a new right knee, but will not have it done. Better the pain I know than a worse situation like I have now.

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I am thinking like you, my foot still 50% numb after TKR 15 months ago, NO CHANGE. I could use a new knee on the other leg but fear consequences, (nerve damage). Bottom line, you take a big chance with this TKR but they won't tell you that, not good for business. I still believe if the orthopedic surgeons took more care instead of doing two or three knees before lunch there would be less nerve complaints, but that would be bad for their bottom line.
I talked to a neuro surgeon about my numb foot and what the orthopedic surgeon did, he just put his head down and shook it. Good luck pal we both need it.

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8 weeks after my TKR both feet are so painful i can’t stand or walk

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@b42

8 weeks after my TKR both feet are so painful i can’t stand or walk

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What should I do

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@b42

What should I do

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Good evening @b42 and a hearty welcome to Connect. I am so sorry to read your post about your feet. Have you been diagnosed with any other conditions that have body sensations? I did not have this problem after my TKR and I have another TKR in a couple of weeks. So, my dear, I am very interested in your unwelcome situation.

It would be great if you could tell us more and whether you have related your symptoms to your surgeon. In the meantime, the best treatment I can recommend is MFR, Myofascial Release therapy. Twice a week I have the therapist work on my feet to get feeling back into them that is not pain or numbness.

If I did not do the MFR, I would not be walking or driving. So, even though you have not been diagnosed with any form of neuropathy.....these symptoms are certainly present.

If you can, please try a Yoga pose called "Legs up the Wall". You can find good explanations on Youtube. I do that at least once a day if not more. When you are in that position, flip your feet back and forth if you can. And then turn your ankles round and round.

Please let me know if this helps. Are you already scheduled for exercise with a PT?

May you be free, safe, and protected from inner and outer harm.
Chris

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Thanks so much Chris for your encouragement and helpful ideas. No I have not been diagnosed yet since this just started three days ago. I have an appointment Monday with my doctor. So I have a list of questions for him. I’m scheduled for my right knee TKR in two weeks so I don’t know if I should postpone it until I get some answers about my feet! What is your advice please?

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@b42

Thanks so much Chris for your encouragement and helpful ideas. No I have not been diagnosed yet since this just started three days ago. I have an appointment Monday with my doctor. So I have a list of questions for him. I’m scheduled for my right knee TKR in two weeks so I don’t know if I should postpone it until I get some answers about my feet! What is your advice please?

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Good morning @b42. I am happy to see that you have an appointment with your doctor. Is this your neurologist or orthopedic surgeon? My advice is to attempt to have a shared decision session with your clinician. This should be an environment where you can talk about your concerns and current symptoms. How are you getting around if you can not walk or stand? Are you in a wheelchair?

If it were me sitting there I would want a diagnosis and prognosis before surrendering my body for more surgery. Is your right knee quite painful? What kind of TKR surgery are you having? A Mako robotic? Something else? What is your level of trust in this doctor's opinions?

Good luck and please let me know the outcome.
Chris

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