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Leg length difference after TKR! What can be done?
My sister, who also has chronic venous insufficiency, had a total knee replacement at the end of February. Has been doing exercises, going to PT, but after more pains, her PT suggest she start using a cane. Pain in legs and lower back. Finally PT measured her and said her "new knee" leg is 1.6 inches!!! longer than the other one. She is devastated that she is now in worse pain than she was before TKR. She was told to build up the shoe of her shorter leg and find someone to add to the bottom of the shoe as well. Now she can't walk around barefoot anymore but has to put on shoes to ease the pain even a little. What can she do? Any suggestions?
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UPDATE: Just back from the ER here in central Maine, wearing a plastic boot. I'd done my normal morning chores wearing a shoe with an elevated heel, walked across my soft bedroom rug, and felt something go SNAP! From that instant, I've been unable to put any weight on the right foot.
The ER doc did an x-ray, said no fracture (probably only an MRI would clarify but it would take >4 months to schedule one due to my pacemaker).
From my discharge: The right ankle is moderately swollen with no warmth, erythema, ecchymosis or deformity. There is ttp [must mean tenderness to palpation, since I don't have thrombotic thrombocytopenic purpura!] over right mid-foot with no induration, deformity, no open wound.
"The achilles is intact included a normal Thompson test and ankle drawer is stable. There is normal sensation to pin-prick and normal capillary refill. There is a normal dp and p.t. pulse, stable, symmetric knees on anterior, posterior, valgus or varus stress."
They're calling it "an injury to one of the ligaments in the feet. Ligaments are strong tissues that connect bones to each other. The ligament can be stretched too much. In some cases, it may tear. A tear can be either partial or complete. The severity of the sprain depends on how much of the ligament was damaged or torn."
They advise: "Rest, ice, pressure (compression), and elevation (RICE--raising your injured foot, and keeping your foot in a fixed position (immobilization) for a period of time. This is done if your ligament is overstretched or partially torn. The purpose of the walking boot is to keep your foot from moving until it heals."
Geez, just when I thought the heel riser had me halfway recovered from the pain on the side of my foot.
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1 ReactionHi, Edith. I have a leg length discrepancy and have been considering a limb lengthening surgery to correct it, but the surgery and its long recovery period (likely not close to home if I do this at the Mayo Clinic) sound very intimidating. I am currently using increasing sized shoe lifts to get myself closer to even to combat all of the various pains that have come from the discrepancy. Would you mind telling me a little bit about your experience with this surgery and its recovery? I have been told it’s a lot more common in younger people, but that people in their fifties, sixties and even seventies have successfully had this done too. Thanks for any insight you are willing to share!
I had the leg lengthening procedure some years ago in mid life. It's difficult without a doubt but had a good outcome. My left leg was shorter given a fracture and it got evened out with the procedure.
Where did you have this done and what is the name of the doctor? That is unacceptable and dont want to accidently pick him for my 2 knees I have to have done.
I agree, this surgeon should be bending over backwards doing anything possible to help you.
This has happened to me. Confirmed by CT scan but 15 months later I still have no answers I'm fighting against institutional protection. So far I've been told - 'it can't happen, it's your back ( I've suffered an acute disc herniation and need back surgery now), your leg was bowed before surgery ( it wasn't), it's muscular or, the best yet, you only THINK it's longer. It's a disgrace and this is private health care. 15 months now with foot and hip problems getting worse, my right TKA is deteriorating rapidly due to compensatory behaviour and as I mentioned severe back issues. Surgeon has run for cover. No answers.
I had a similar result after a doctor raised the fallen arch in my right foot. I still had the same pain after the cast came off as I had before the surgery. The doc checked an exray done 11 months after the surgery and discovered that the pain was from arthritis in the joint of the little toe on that foot. Within 6 to 8 months the doc left the practice for a position somewhere far away. Now, I need extra padding equal to about 1/2 inch to equalize my leg lengths. Also, the months without the padding caused unequal wear and shortening of my spine, which has left me with severe lower back pain. There is a 2 year limit on seeking correction of a medical “mistake” in my state. The deadline is long past.
My left leg is 1/2 inch longer after revision. I didn't have any pain for 7 years until recently