Foot neuropathy (numbness and pain) after total knee replacement (TKR)

Immediately following my total knee replacement and nearly four months since the surgery I have since experienced the following two symptoms:

1. Superficial (not deep) nagging nerve pain and inflammation on the outside of my foot and both side of my ankle
2. Stiffness and extreme tightening of my thigh muscle just above my knee and into the lower half of the thigh muscle (felt like it was shortened). This has slowing gone away with regular and continued stretching and physical therapy

What can be done to help my foot and ankle? Ibuprofen helps

Typos:
Meant both sides of my ankle
Meant This has slowly gone away...

Mark Weems

Welcome Mark @markweems, Sorry to hear you are having some ankle pain following your knee replacement. Here is an explaination and hopefully some tips that may help with your ankle pain.

(3) Tips to STOP Ankle Pain After Total Knee Replacement

This is so true, referencing the EMG. I HAD THS SAME TEST after TKR because of foot neuropathy and for my age
(74), the doctor performing the test basically said I had some deterioration but nothing significant. Big help that was. Two years after TKR and still suffering (at night) with feet neuropathy. Also have an enlarged (swollen) lymph node in my groin but the second surgeon’s opinion was that it should eventually resolve itself. He clearly blamed it on TKR.
I think he may be onto something, the swelling appears to very slowly disappearing. Another ultrasound scheduled for early November will tell me more. Meantime the neuropathy continues to be a major issue and not getting any better. I agree with the one gentleman above, DON’T BELIEVE THE SURGEON ABOUT GREAT RESULTS, in my opinion, they all lie and hope for the best. Maybe that’s all we can expect.

Three years ago I had a right TKR and have had pain in the replacement knee, hip, back, foot pain ever since. It has changed my gait and I now have problems walking with my feet leaning in on my arch, and instability. Now the doctors are classifying me as knock knee. I never had knock knees previously. I am delaying having the right knee replaced due to all the problems I have had since the right replacement and am getting those gel injections for my left knee, which have reduced the pain. I too am concerned about all the additional pain problems I have had and agree with the comment about changes it makes to your alignment and after a lot of therapists and no one resolving anything I am not agreeing to adding to the problem with another knee on the left side. In fact it appears that the therapist don't have a clue and don't seem to have any interest in solving this and am getting no where with visiting different orthopedic sugeons trying to find answers. I am angry and a bit frustrated that they do the knee replacement and have no answers to all the pain I experience since. Seems to me they should be more responsible in results than just doing the surgery. Maybe the next step is a rehab specialist, don't know.

Correction: I am delaying having the left knee replaced due to all the problems.

I'm sorry you have been suffering with pain after your knee replacement. Even the most meticulous surgery can cause unanticipated changes in our body mechanics. Like you, I found most surgeons to be uninterested in addressing the issue. Once the wound is healed and the implant is solid, quite a few feel their job is done - even when the patient is still suffering. Unfortunately that is because the surgeon is paid by insurance to operate. Some go the extra step, others are constrained by their practice policies or insurance companies, we just never know the "back story."

Also, there are many kinds and skill levels of physical therapists and therapy centers. Many seem to be "cookie cutter" clinics - with the minimum required number of actual certified therapists, and the remainder are physical therapy assistants, who simply supervise a set list of exercises that is their protocol for for each surgery or injury. Again, this may be due to how they are paid, and the rules governing numbers of sessions, etc.

Your idea of visiting a rehab specialist sounds just right to me. My best experiences were with a rehabilitation therapist associated with a center that handled complex cases - limb loss, traumatic injury, multiple surgeries, etc.

This was done on referral from my ortho doc, and covered by insurance due to "failed traditional therapy." It involved an extensive evaluation of alignment, gait, strength, flexibility and my goals. Then a custom program was set up including land and water therapy and extensive at-home exercise routine. It took many months, but the hip, back, neck & leg pain from my badly misaligned body was finally controlled.

May I suggest that you approach your surgeon with this request, and if they turn you down, ask your primary provider? People can share their stories and experiences on Mayo Connect, but at the end of the day you need to become your own best advocate.

Can you locate a rehab center or practice near you?
Sue

Thank you for the video... Will get started on the three ankle PT right away...

I had TKRs on both knees this year. The surgeon used the Mako robotic assistant.

The first surgery in March was fine. Swelling came down, motion came back, and it felt like I was fully recovered in six weeks. Second surgery was in July. Motion came back but slight swelling has been stubborn. Pain in both knees is gone.

But the skin around my knees and part way down my shin is numb, or at least somewhat numb. Surgeon said that is normal and feeling may come back, may not.

So while this is nowhere near the problem you are having, like you, I wasn't warned in advance of this. It seems like some type of nerve damage, and personally, I don't hold out a lot of hope that this will change.

But I do hope your foot gets better. Not being able to touch your foot or put on a sandal is ridiculous, especially if you weren't warned that this is a possible side effect.

All the best to you. Joe

I’m 16 mths post tkr & do hv neuropathy mainly in the Tkr foot. It includes toe pain, extreme irritation under big toe joint (in both feet) for which I use a cold pad that helps. I also use CBD oil for sleep & hv CBD salve that I massage into my foot & it also helps the arthritis in both hands.