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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@gator1965

I am nearly 8 months following my total knee replacement. I have a neuropathic type of pain which has been present since the replacement. I have a numbness and tingling type sensation which is constant, and i cannot bear anyone or anything touching this part, it sends out a shooting type of pain. Initially I could not even have a sheet over it. I also have a burning type of pain down my leg. My physio recommended that I try different textures rubbing the knee to desensitise the area from towel, tissue to toothbrush! I haven't tried the toothbrush yet!!
I do still experience swelling to the leg
My surgeon prescribed baclofen and amitriptyline at night. My GP is still juggling the dosages around, and I am still taking regular paracetamol and brufen.

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Just a quick remedy that helped me. I put a foam roller at the end of my sheet so nothing would touch my toes. It really helped

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@artscaping

Good evening @phigg. Good for you. I hope you find some treatments that really work for you. I know that everyone is different ........and it takes a good bit of time to try different options. Regarding your question about finding MFR-trained therapists......I think you have to ask for John Barnes certified folks. They have committed hundreds of hours and even years to studying and practicing MFR to assure the release of the restricted fascia. I choose to see only those with an EXPERT level certification. You may find therapists near you on this website: http://www.myofascial.com. Just check on "Find a Therapist".
Good luck. Let me know of any questions or concerns you encounter.

May you have happiness and the causes of happiness.
Chris

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Well, here is a different kind of TKR issue.............possible IMPLANT FAILURE. I have had 2 TKRs. The first in 2015 was PERFECT and had little discomfort. I had 2nd TKR in 2018 by a different surgeon/hospital. It wasn't bad, recovery was overall good enough, BUT...........
I think they clipped a nerve (I have had numbness in leg for 3 yrs.). I can deal with it, but
sometimes when I run playing a racquet sport I have a calf flutter and my leg hesitates to take the next step. My foot now turns out. That knee is always a little swollen, knee/leg somewhat unstable; my balance is a bit off; my body is "pitched forward" when walking or when I bend forward; that leg does not pivot well; it is not painful (but I believe I have a high pain threshold). I have communicated many times w/ Dr. for xrays and trouble shooting with no insightful resolution or ideas.
WELL, HERE IS THE NEW NEWS AS OF LAST WEEK AND I AM UNSURE HOW TO HANDLE!!
My hospital (very highly respected in orthopedics) sent me a letter. It seems I am in a group of TKR that may have a RECALLED implant component (!?) It is Tibial Insert/Liner. It acts as cartilage/cushion for 2nd TKR between lower leg (Tibia) and upper leg (Femur). Apparently, when the part was packaged it may have let in oxygen which can cause oxidation that can weaken that part when in the TKR. I am in the process of trying to communicate and getting yet another Xray. However, I have several problems that are not exactly what they refer to but can be related (numbness, muscle "flutter", some knee swelling, instability/balance issues).
If they find my insert is a problem, is it in my best interest to re-do part of the surgery? or live with it? or get some sort of support from hospital? The hospital does not claim responsibility; they feel it is the manufacturer of the Implant part and they both may be in agreement on this.
I have always been very healthy, very physically active. Am 70+. Over the past few yrs. I have increased back issues (herniated discs and stenosis) - Last year had SEVERE thigh pain in one leg for 3 months and a more bearable thigh pain in the other leg. Do not know if this is related. I have had a ton of PT and do my exercises. And I hope people do not "blame" all this on aging; because I do not.
I do not know if these are all connected, but the big Q. is what are my real options if it turns out the implant is causing a problem? Would revision surgery be POSSIBLE?, ADVISABLE? OR EVEN LOGICAL?
Thank you anyone for any thoughts.

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@libertyusa

Well, here is a different kind of TKR issue.............possible IMPLANT FAILURE. I have had 2 TKRs. The first in 2015 was PERFECT and had little discomfort. I had 2nd TKR in 2018 by a different surgeon/hospital. It wasn't bad, recovery was overall good enough, BUT...........
I think they clipped a nerve (I have had numbness in leg for 3 yrs.). I can deal with it, but
sometimes when I run playing a racquet sport I have a calf flutter and my leg hesitates to take the next step. My foot now turns out. That knee is always a little swollen, knee/leg somewhat unstable; my balance is a bit off; my body is "pitched forward" when walking or when I bend forward; that leg does not pivot well; it is not painful (but I believe I have a high pain threshold). I have communicated many times w/ Dr. for xrays and trouble shooting with no insightful resolution or ideas.
WELL, HERE IS THE NEW NEWS AS OF LAST WEEK AND I AM UNSURE HOW TO HANDLE!!
My hospital (very highly respected in orthopedics) sent me a letter. It seems I am in a group of TKR that may have a RECALLED implant component (!?) It is Tibial Insert/Liner. It acts as cartilage/cushion for 2nd TKR between lower leg (Tibia) and upper leg (Femur). Apparently, when the part was packaged it may have let in oxygen which can cause oxidation that can weaken that part when in the TKR. I am in the process of trying to communicate and getting yet another Xray. However, I have several problems that are not exactly what they refer to but can be related (numbness, muscle "flutter", some knee swelling, instability/balance issues).
If they find my insert is a problem, is it in my best interest to re-do part of the surgery? or live with it? or get some sort of support from hospital? The hospital does not claim responsibility; they feel it is the manufacturer of the Implant part and they both may be in agreement on this.
I have always been very healthy, very physically active. Am 70+. Over the past few yrs. I have increased back issues (herniated discs and stenosis) - Last year had SEVERE thigh pain in one leg for 3 months and a more bearable thigh pain in the other leg. Do not know if this is related. I have had a ton of PT and do my exercises. And I hope people do not "blame" all this on aging; because I do not.
I do not know if these are all connected, but the big Q. is what are my real options if it turns out the implant is causing a problem? Would revision surgery be POSSIBLE?, ADVISABLE? OR EVEN LOGICAL?
Thank you anyone for any thoughts.

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Personally, I would want a new implant. However, to avoid additional costs, you might want tot contact the manufacturer who should cover all of the costs. Perhaps a class action suit composed of all of you that are effected. Best of luck.

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Actually, the Hospital said implant manufacturer is covering costs. But I do not know how far they go?
They include: Xrays, Dr. visits, tests. I would assume new surgery? The letter points out "low probability"
that the insert will cause problems...............but that is hard to assess and measure. And at what stage might you do it? Now or when it becomes a serious issue. A lot of "what if's"
A class action would require a lawyer . I know little about that type of action.
But thank you for your interest.............this comes at a bad time for me (probably never is a "good" time though).

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@libertyusa

Well, here is a different kind of TKR issue.............possible IMPLANT FAILURE. I have had 2 TKRs. The first in 2015 was PERFECT and had little discomfort. I had 2nd TKR in 2018 by a different surgeon/hospital. It wasn't bad, recovery was overall good enough, BUT...........
I think they clipped a nerve (I have had numbness in leg for 3 yrs.). I can deal with it, but
sometimes when I run playing a racquet sport I have a calf flutter and my leg hesitates to take the next step. My foot now turns out. That knee is always a little swollen, knee/leg somewhat unstable; my balance is a bit off; my body is "pitched forward" when walking or when I bend forward; that leg does not pivot well; it is not painful (but I believe I have a high pain threshold). I have communicated many times w/ Dr. for xrays and trouble shooting with no insightful resolution or ideas.
WELL, HERE IS THE NEW NEWS AS OF LAST WEEK AND I AM UNSURE HOW TO HANDLE!!
My hospital (very highly respected in orthopedics) sent me a letter. It seems I am in a group of TKR that may have a RECALLED implant component (!?) It is Tibial Insert/Liner. It acts as cartilage/cushion for 2nd TKR between lower leg (Tibia) and upper leg (Femur). Apparently, when the part was packaged it may have let in oxygen which can cause oxidation that can weaken that part when in the TKR. I am in the process of trying to communicate and getting yet another Xray. However, I have several problems that are not exactly what they refer to but can be related (numbness, muscle "flutter", some knee swelling, instability/balance issues).
If they find my insert is a problem, is it in my best interest to re-do part of the surgery? or live with it? or get some sort of support from hospital? The hospital does not claim responsibility; they feel it is the manufacturer of the Implant part and they both may be in agreement on this.
I have always been very healthy, very physically active. Am 70+. Over the past few yrs. I have increased back issues (herniated discs and stenosis) - Last year had SEVERE thigh pain in one leg for 3 months and a more bearable thigh pain in the other leg. Do not know if this is related. I have had a ton of PT and do my exercises. And I hope people do not "blame" all this on aging; because I do not.
I do not know if these are all connected, but the big Q. is what are my real options if it turns out the implant is causing a problem? Would revision surgery be POSSIBLE?, ADVISABLE? OR EVEN LOGICAL?
Thank you anyone for any thoughts.

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Wow! No words

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I had my TKR in 2018 and the problems since have been unreal. Well one of the problems was foot neuropathy and I found great relief from CBD Cream / with TCH in it. I found rubbing a good amount on my foot would give me relief for 3-4 days at a time then it would come back, so everytime I would reapply and good results again . Over the 3 1/2 yrs the foot is no longer any problem. Was it the cream or time ? I don't know but it;s gone , now if the other problems would go away I could be a happy person again. BEST OF LUCK

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After first tkr in 2016 very mild numbness tingling in both feet. Seemed to subside. HOWEVER 2nd knee replacement in 2017. A week after both feet numb and tingly and to this day have gotten progressing worse. Tarsal tunnel syndrome is what they diagnosed. 3 yes 3 decompressions to no avail. I am suffering with neuropathy in both feet. Seems my gait changed and my flat feet with new gait is the culprit. Very debilitating and actually ruining my life. Can’t do anything that I could do before. Get what I need to get done done but that is it. Not a happy camper.

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I developed foot neuropathy about 6 mont(s after TKR, never had symptoms prior to surgery. I’ve seen neurologists, a vein surgeon,had an ECG and an
ultra-sound and doctors say everything is fine, but it isn’t. I’ve been prescribed Gabapentin which helps me sleep at night. Most neuropathy symptoms do appear late in the day or early evening. Symptoms are tingling in the bottom of my feet and a burning sensation. I’ve also Devoloped lymph node swelling at the top of my surgery leg in the groin area. Tests results indicate lymph node swelling but appear to be no abnormalities. I’m tired of the term “ideopathetic from all doctors I’ve seen. I am now referred to a general surgeon next week to assess my nymph lobe swelling. Disgusted here. Knee itself has been okay from a functional standpoint.

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@vinran

I developed foot neuropathy about 6 mont(s after TKR, never had symptoms prior to surgery. I’ve seen neurologists, a vein surgeon,had an ECG and an
ultra-sound and doctors say everything is fine, but it isn’t. I’ve been prescribed Gabapentin which helps me sleep at night. Most neuropathy symptoms do appear late in the day or early evening. Symptoms are tingling in the bottom of my feet and a burning sensation. I’ve also Devoloped lymph node swelling at the top of my surgery leg in the groin area. Tests results indicate lymph node swelling but appear to be no abnormalities. I’m tired of the term “ideopathetic from all doctors I’ve seen. I am now referred to a general surgeon next week to assess my nymph lobe swelling. Disgusted here. Knee itself has been okay from a functional standpoint.

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Hello @vinran, Welcome to Connect. I'm not very fond of the term idiopathic either which is my neuropathy diagnosis. I know all surgeries carry a risk and nerve damage is one I was worried about when I had my right knee replacement done. I also had lymphedema prior to the surgery and have to wear compression socks to keep the swelling down. Here's some information I found that talks about what I think you are describing.

"Can knee surgery cause swollen lymph nodes?
The secondary form may be caused by a lesion of the lymphatic vessels and/or lymph nodes during diagnostic or therapeutic procedures such as surgical interventions. Often, in clinical practice, there is lymphedema after orthopedic surgery, even in minor orthopedic surgery."
-- Lymphatic edema of the lower limbs after orthopedic surgery: results of a randomized, open-label clinical trial with a new extended-release preparation: https://pubmed.ncbi.nlm.nih.gov/26753640/

Hopefully your next appointment can provide some answers for you. Can you provide an update after your appointment next week with the general surgeon?

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@johnbishop

Hello @vinran, Welcome to Connect. I'm not very fond of the term idiopathic either which is my neuropathy diagnosis. I know all surgeries carry a risk and nerve damage is one I was worried about when I had my right knee replacement done. I also had lymphedema prior to the surgery and have to wear compression socks to keep the swelling down. Here's some information I found that talks about what I think you are describing.

"Can knee surgery cause swollen lymph nodes?
The secondary form may be caused by a lesion of the lymphatic vessels and/or lymph nodes during diagnostic or therapeutic procedures such as surgical interventions. Often, in clinical practice, there is lymphedema after orthopedic surgery, even in minor orthopedic surgery."
-- Lymphatic edema of the lower limbs after orthopedic surgery: results of a randomized, open-label clinical trial with a new extended-release preparation: https://pubmed.ncbi.nlm.nih.gov/26753640/

Hopefully your next appointment can provide some answers for you. Can you provide an update after your appointment next week with the general surgeon?

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I certainly will provide an update and apprehend information
Thanks

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