Foot problems after TKR

Hello @topdog11, and welcome to Connect.

I had my knee replaced in 2006. Like you, I had not had full function of my leg for many years prior to the replacement. I was a tad different in that I was unable to straighten my leg until after the surgery. I had not had my leg straight for the better part of a decade, and when I woke up from surgery, my leg was straightened out. The pain in my ligaments, muscles, and tendons was immense because I was stretching out parts of my body that hadn't been stretched that way in years.

I am not a medical professional, so it would be best to discuss this with your surgeon or provider, but it sounds like you may be experiencing something similar. I experienced swelling due to what sounds kind of similar to you - using ligaments, muscles and joints in a way they had not been used for many years. In my non-medical expertise opinion, it sounds like you might be stretching and working things that have not been used for many years, and they are responding by swelling.

I have end-stage arthritis in my right ankle and have been trying to refocus on walking heel to toe as well... it is harder than one would think isn't it?

@topdog11, other than your concerns with feet, how is your knee doing with bend and range-of-motion?

@topdog11

Here a few other discussions you may want to check out. Each has many members discussing all things knee replacements:
- Scar tissue after knee replacement, https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/
- Limited ROM after total knee replacement, https://connect.mayoclinic.org/discussion/limited-rom-after-total-knee-replacement/

After talking with my PT, he agrees my foot is swollen and causing me problems because I am using muscles, joints, etc in ways I haven't in many years. Also since I pulled that calf muscle I am not completely walking correctly cause of the pain in my calf. I am in a bit of a catch 22. I need to stretch my leg so I can get it to lay flat but I am not suppose to stretch my calf muscle so it can heal. I also judge myself by how well my husband did with his TKR. He was at 115 bend and -1 straight the day after surgery. I am 2 and 1/2 weeks and have 95 bend and 14 straight, which is just about how it was before surgery. I can tell I am bending it a little easier everyday so there is some improvement.

I can relate completely. I wouldn't worry about comparisons, my recovery was long and painful. It took me well over a year to find my new normal, which ended up being 0-105 degrees. I had to have two manipulations along the way because of aggressive scar tissue formation. But, in the end, I am pain free and my flexion and extension is enough that it does not prevent me from any activities (except using a trampoline!). You will get there, even if it takes more time than others you know.

My ankle was swollen for few weeks after the surgery. Few days after the surgery I forgot to use the compression sleeves, on the operated leg and it really swelled up. I called my doctors office to see if it was normal. They ignored my question completely and asked my about my calf instead. She told me if it’s tight and hurting go to the ER and get checked for a possible blood clot. Luckily, it only cost me the ER fees, and no clot. So please make sure that you rule out the blood clot.

As for as walking is considered, just watch any 4 year old kid to see how they walk. They don’t use heel to toe, instead it’s the whole foot forward and they never straighten their knees. Following that method I was able to walk few miles a day before my tkr, instead of few hundred feet with a bone on bone knee which was completely worn out. This is also called CHI walking. I tried to find a good link for chi walking but unfortunately couldn’t do so. There are too many people pretending to be the experts on the topic with crazy videos.

I’ve told by some serious marathon runners at the gym that they use the whole foot, not the heel to toe.

My R foot is deformed since birth; it rolls inward (no arch) and I use a custom orthotic. Now I need TKR on the right knee, and the leg will of course be perfectly straight afterwards. What will the effect be on my foot, and how severe will it be? Can it prevent the healing of the TKR? Suggestions very much appreciated.

Oh my I can relate to that. I was so anxious to start walking and doing things like years ago before my knee got so bad. the first couple of months seemed promising. I no longer had any pain in my knee after a few months. The knee was great. Then I started to have swelling in the surgery leg in my foot. The surgeon said they had to turn my leg and that the muscles needed time to adjust. It seemed to get worse and they sent me to a ortho foot doctor who had no clue what was going on and sent me to imaging center to see if I had a blood clot. Then he fit me with a brace. Why he didn't know that this was a common thing I don't understand. To make a long boring story short.....I went to several doctors none seem to have a clue, I was given prednisone, antibiotics and many other wrong diagnosis. I started researching for myself and found out this is a common problem. plantar fasciitis and neuropathy is just one of the problems that can develop from having your leg turned in TKR surgery. So I am going to go back to a foot doctor and discuss what I found. Hopefully in time the foot problem will resolve enough to have good use of my leg again. I'm in my 8th month since my TKR. Also the foot on my surgery leg was always a flat foot, so when I discussed this fact with the doctor as an additional possibility for problems, he dismissed it saying "it just needs time"!! I find you have to be your own advocate and research as much info as you can. :[

I’m over 5 months PO and my ankle swelled and it hurt to walk. Finally went to my foot surgeon. I’d developed Sinus Tarsi. He gave me a cortisone shot. He said with this syndrome, it should be cured with one or two shots. I think it was created by my new alignment and gait. Hope you feel better soon!

After my second set of hip replacement surgeries, I needed "gait training" from PT, new orthotics from my foot doc, and (UGH!) to replace all my shoes that had any wear on them. My lower body alignment & foot position was so changed that wearing anything from before cause much pain. Even now, 11 years later, I must carefully test shoes at home with my orthotics, before keeping them. And NO flip-flops or slides, not even the "good ones" except for very limited use - to the mailbox, to the pool...
Written as I am trying out some new shoes I got last week - I think they are keepers.
Sue

Thank you! Since my surgery I saw a foot doctor 2x, family physician in between. The foot doctor did not treat anything...sent me to an imaging center to make sure there was no blot clot. I had to research to find that many people with TKR where the leg had to be straighten had foot issues. Why in the world did the foot doctor not know this. I even asked him if it could be an issue because they had to turn the leg. He didn't even acknowledge it! I spent a few dollars to come full circle to absolutely nothing. And quite a few medications which didn't help the problem. No one address the "gait" problem, I had to read it online. May I ask what kind of shoes your wear (you mentioned you bought new ones) Thank you for replying and affirming I have a problem from the surgery. No one I went to would even address that. I guess they were afraid to say that.....I don't really know, but I'm not trying to point a finger I just want them to find the problem and help me recover the foot. Its so bad now I had to quit driving. So I called and they are sending me to a "foot specialist", but he is full and will call when I can get an appointment. Hope its soon. Have a good day!