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

I am sorry to hear you are having the pain, and it is definitely something to ask your doc about. Please don't be surprised or upset if he examines you and says that it is "normal" for your stage of recovery and will go away. What is most frustrating, of course, is that most pain meds don't touch nerve pain, so it quickly becomes a focal point of our day or night!

During joint surgery, many nerves are assaulted - irritated, bruised, repositioned, maybe even cut as part of the operation. Each of these must heal, and they do so at their own VERY slow pace. Some of the symptoms of nerves healing are numbness, tingling, burning, feeling cold or hot, even stabbing. The pain changes depending on the nerve involved and the stage of healing.

When I had my hip replaced, the numbness started at the incision and went all the way to my little toe. There were many changing sensations over time, and after about 6 months I was left with one permanently numb area (about 6") along my femur. I also experienced long term numbness, pain & tingling in my shin & foot for almost a year after a traumatic knee injury & ACL/MCL surgery, but it eventually resolved.

After my experiences, and a lengthy explanation by my excellent PT team of the nerve healing process, I realize many people will have nerve issues after major surgery. My PT explained that if I could change the pain with position change, massage, ice or heat it probably wasn't too concerning - just a sign of healing. If it didn't change, not matter what I did, and it persisted for a day or more, or there was new swelling, or it was discolored or hot or cold, it was time to call the doc.

2 weeks is early days yet - be gentle with yourself as you heal, do your PT even when it hurts (and it will!) and come back with your questions. There are a lot of experienced survivors here who can share with you.
Sue

Y’all have truly been very informational and informative. I love this forum post as many people will blow you off and say it is normal. I pray this is just a part of healing and that the issues I am having will resolve once I have completely healed. Fingers crossed. Will definitely be back to give updates.

Ask for and ABI test - simple ultrasound to test the pressure in your legs. Mine had very little pressure in that leg so I saw a cardiologist who ordered the angiogram which found the blocked artery.
Hope all went well at your appt. today. Take Care.
Lori

I had that test and everything was fine, according to a surgeon I saw who was unrelated to my TKR. However,
even after that and many tests, no one can come up with an answer to my “sudden” foot neuropathy after TKR.

I was told the same thing, however, after two years, nothing has
gone away. If anything, the foot neuropathy has worsened. I will
have another ultrasound because I’ve since noticed a swelling in my
groin area which is same leg that I had my TKR. TURNS OUT to be a
swollen lymph node and they can’t find a thing from the first ultrasound.
A second ultrasound is scheduled for next month to determine if any thing
has changed. I can tell already by the swelling that it’s unchanged after 5
months. At that time, I will also ask the surgeon for the ABI test that was
mentioned by Lori.
Honestly folks, I think knee surgeons “hide the truth” about repercussions
such as neuropathy etc…. after TKR. I no longer trust any of them! I’m seeing
an unrelated surgeon as I move forward in my journey to hopefully determine
WHAT IS CAUSING MY PROBLEMS.
Keep posting please, it helps everyone.
Thanks.
Vince

It’s good to rule out everything. Sorry you haven’t found an answer yet. But don’t give up.

Hi,

I am glad you mentioned all the symptoms you had after your THR. I am seven weeks out from THR, and I am getting burning, tingling, stabbing and even electrical type shocks down my thigh from the surgical site. I think I was just not prepared for this by the doctor. It would have been good for surgeons to have a discussion of the types of "normal pain" to expect versus pain indicating that you should contact the doctor. When these symptoms flare up, it is hard to not think there is something very wrong with the hip replacement surgery itself. Thank you for the reminder that joint replacement is major surgery and the damage and irritation to the nerves and muscle will take time.

Yes,
I also am experiencing same foot neuropathy.
Post 22 weeks TKR.
Burning\cold throbbing pain on top of foot at webspace of 2nd\3rd toes.
I beleive its due to the tornequet the Anestesialogist strapped on me just before putting me out for the procedure.
He said "Its so we can give you a nerve block in the upper thigh" But the surgeon later (1st post visit) said its also so "You dont bleed into the joint during the first part of procedure" and that it was only on for 15 minutes.
Days later at home, and after the nerve block wore off, I experienced some really sore upper thigh pain with yellowing\black and blue soreness on side of and behind the thigh. DR said it was from the tornequet.
So, I beleive the Deep Peroneal nerve (from the hip to the webspace of 1\2nd toes was compressed by the tornequet strap and I'm now living with a new pain I never had before this TKR.
The Dr has had me on and still on (Gaberpentin and Celebrex). I see him in 3 weeks for 6 month post visit and will INSIST he send me to a neurologist for he foot burning pain.

The tourniquet was put on my thighs very tightly during my two TKRs this year. I don't have any after effects, but was surprised at the amount of bruising it caused on the inside of my thigh all the way up to my groin.

I haven't heard of this causing nerve damage. I'd see a neurologist as soon as possible.

Sorry for what you're going through and all the best.

Joe

During a Sesmoidectomy on RF in 2008, I was informed by the DR (during post follow-up)
"My assistant had to spread the foot incision wider in order for me to get in and it required compressing the Deep Peroneal Nerve".(DPN).
After that surgery I experienced Immediate cold burning throbbing pain on top of foot at the web space of 1st\2nd toes. It was horrible and constant. I was then put on Vicodin for awhile, then I found a D.O. who treated pain mgmt with "RFA" RadioFrequency Ablation). A electronic needle that burns the nerve just enough to disrupt the pain signal to the brain. It worked, for abour 3 months then repeated with longer relief gains. The problem was in trying to find such a small narrow nerve with Ulrasound and the nedle, the pricking the web space with a needle trying to find the DPN resulted in the DPN in the web space becoming injured by the needle over time (Found that out later by Neuro. After a few years of that....I sought a Neurosurgeon for opinion and after ordering a a nerve conduction study (NCS), it revealed the DPN in the web space was screaming in pain.
The Neuro did some other tests (Foot Nerve Block) to see if that indeed was the DPN causing the pain. He then concluded that "The DPN in the foot was likely diseased and recommended a Neurectomy and cut out a 1inch piece of the DPN between 1st\2nd web space. After THAT painful recovery (1.5 years) the pain went AWAY..
Page foward 14 years to now and AFTER the TKR procedure my foot is SCREAMING in pain and cold burning..
I believe its due to either

1 - The tourniquet on the upper thigh, or
2 - Deep Vein Thrombosis (DVT) I developed (Or was sent home from the hospital WITH) 1 day after I was discharged from TKR and the nerve block wearing off. I was made aware of the DVT at 7 days post when I couldnt move the leg due to intense pain or get out of bed. THe home Therapist who came to start 1st day of post surgery home therapy saw how swollen and reddish\purple my lower leg was and called the Dr office and they said to "Get him hear now". Had to go by ambulancedue to not being able to move my leg or bend it(7 days post TKR and never made it out of bed). They did Ultrasound and said 5 large clots found) sent me home with blood thinners (And the excuiating now lower leg pain of DVT pressure throbbing pain like you can not imagine). So at that point I was dealing with having to recover from a TKR and NOT being able to begin threapy or get out of bed, I'm also dealing with DFT and intense lower leg pressure pain. When the DVT pain started to subside (2-3 weeks later) I began feeling the DPN pain in the foot web space which I have at this moment as I write this (5 MONTHS POST TKR)