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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@loriaakre

I had the same problem, like you foot was totally asleep and felt nothing but pain numbness and tingling. I was told by my surgeon it was normal and would go away. They did ultrasound looking for DVTs in my veins but found nothing. I went home miserable and in tears. I kept seeking help but got none. At my 3 wk check was told again it’s normal. At 6+Weeks we saw our primary who said it’s NOT normal. Did an ABI ultrasound and found I had a blocked popliteal artery and had surgery to fix that. They said it was from my TKR surgery. The tingling n numbness got better but is not totally gone. With no blood flow to my foot for 60 days more than likely caused cell n tissue damage and is probably permanent. Will be 2 years Feb. 12. I contacted a lawyer but my surgeon put nothing in my visits about my numb foot so case was dropped. I just can’t believe doctors get away w lying in medical records. I just have to live w a miserable foot, painful knee and a limp worse than before tkr.
Good luck and be an advocate for yourself.

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They did a ABI yesterday on his foot and said he barely has any blood flow in his foot...they are tellin ghim it is PAD.

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@staudek

They did a ABI yesterday on his foot and said he barely has any blood flow in his foot...they are tellin ghim it is PAD.

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I looked up the medical term PAD and yes it is reduced blood flow to the lower leg. I was never told it was PAD after my ABI, I was just sent to a cardiologist who set me up for an angiogram which showed the blockage of the popliteal artery behind my knee that supplies the blood flow to your lower leg and foot. Once that was opened by a surgeon who specializes in artery and vein surgery my foot was a good 60% better. Not quite as numb or tingly but my toes were NOT purple and my foot was warm. But since the 60 days of numbness etc... there is probably permanent damage to cells and tissue. When I told my TKR surgeon he just said "why did you wait so long to get it fixed you could have lost your leg" told him because he didn't listen to me after surgery or my 2 week after visit!!
Be an Advocate for yourself and keep pursuing your problems.
Good Luck and keep me informed what you find out.

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He is schuled for an angiogram next sat. Today he went an had nerve studies and the Dr said his nueropathy is in his foot was caused by spinal stenois in his lumbar region...I find that hard to believe since he had no problems whatsoever with his foot until the minute he woke up from surgery complaining his foot was asleep.....

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@staudek

He is schuled for an angiogram next sat. Today he went an had nerve studies and the Dr said his nueropathy is in his foot was caused by spinal stenois in his lumbar region...I find that hard to believe since he had no problems whatsoever with his foot until the minute he woke up from surgery complaining his foot was asleep.....

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Hi Staudek- I am not sure what lumbar stenosis is. Can anything be done for it? I had incredible pain on my foot when I woke up from surgery, felt like a truck was sitting on it. Nurses put ice on it and left it on for hours. I was out of it with the pain, but it felt numb also. I remember a nurse said at one point something like," Oh my God, how long has the foot been iced? It is frozen". It will be 2 years after surgery at the end of this month. My foot was really painful and numb for months. The first weeks, it was excruciating to have the sheet touch the foot when I lay in bed. It kept getting better as I did intense exercise (cycling, etc.) and symptoms were only slight and intermittent almost a year later. Then I fell off a ladder and broke the foot just a week shy of a year after knee replacement. Unfortunately, by the time I got the boot (which I wore to immobilize it for about 4 months) off, I had very severe numbness again. It got better when I cycled a lot in July, August and September, but since winters here in Vermont do not easily allow for outdoor cycling, it has been getting worse and worse the past months. It is hard to explain the sensation. I can feel the toes when I pinch them, but they feel numb or enlarged (not swollen) otherwise, especially later in the evening, and the whole foot hurts when I do much walking. Does anybody else have the "numb but feel" sensation? How do you describe it? It just does not feel normal.

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@staudek

He is schuled for an angiogram next sat. Today he went an had nerve studies and the Dr said his nueropathy is in his foot was caused by spinal stenois in his lumbar region...I find that hard to believe since he had no problems whatsoever with his foot until the minute he woke up from surgery complaining his foot was asleep.....

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I had nerve testing done as well and was told as well that the numb foot issues was from my spine. I did have a spinal steroid injection in my spine in the S1/L5 area. it did help the pain from my back to knee but not down to my foot. I never had issues with my spine before my TKR but depending on the doctor you see, they say the problem was from my knee because I walk/limp still or could have been damage from the nerve block when the knee was done. Others say nothing to do with my knee. go figure they all look out for each other.

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@erikas

@marynajdek I'd like to extend my welcome to Mayo Clinic Connect. @butter12 Welcome to Mayo Clinic Connect and @bluebrass I'd like to welcome you back to Mayo Clinic Connect.

All of you had complications related to total knee replacement and have that experience to share.

@butter12 You have regained full mobility 6 months after surgery but you still experience neuropathy. You are considering surgery for a pinched peripheral nerve and you are wondering if they will first suggest weight loss?

@bluebrass It sounds like your experience was similar.

Members like @sunnybuns1 @anncgrl @loriaakre @glokart1957 @navyqas @suewilliamaon @janedahlgren @josie1957 have discussed this topic and may be able to offer support.

@butter12 May I ask how physical therapy went and what your physical therapist had to say about the neuropathy?

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Erika, don't forget to mention me. I wrote a lot about my foot neuropathy.
Lori S. (Irol)

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@loriaakre

I had nerve testing done as well and was told as well that the numb foot issues was from my spine. I did have a spinal steroid injection in my spine in the S1/L5 area. it did help the pain from my back to knee but not down to my foot. I never had issues with my spine before my TKR but depending on the doctor you see, they say the problem was from my knee because I walk/limp still or could have been damage from the nerve block when the knee was done. Others say nothing to do with my knee. go figure they all look out for each other.

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Yes, when I went to my surgeon for a followup, he would not even let me finish describing my foot problem and interrupted me, saying that it had nothing to do with the knee surgery. (It was incredibly painful and had numbness later as soon as I woke up in the recovery room). I made a special appointment to talk about the foot a few months later and he had me see the PA, not him, and she kept changing the subject and would not address any causes of the foot neuropathy as being connected to the surgery. Have you requested and read all surgery notes? Maybe you should find out how long the tourniquet was on your leg during the surgery. Over 45 minutes can cause nerve damage, I think. Maybe there were other irregularities...although they may not have recorded a problem..

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@loriaakre

I looked up the medical term PAD and yes it is reduced blood flow to the lower leg. I was never told it was PAD after my ABI, I was just sent to a cardiologist who set me up for an angiogram which showed the blockage of the popliteal artery behind my knee that supplies the blood flow to your lower leg and foot. Once that was opened by a surgeon who specializes in artery and vein surgery my foot was a good 60% better. Not quite as numb or tingly but my toes were NOT purple and my foot was warm. But since the 60 days of numbness etc... there is probably permanent damage to cells and tissue. When I told my TKR surgeon he just said "why did you wait so long to get it fixed you could have lost your leg" told him because he didn't listen to me after surgery or my 2 week after visit!!
Be an Advocate for yourself and keep pursuing your problems.
Good Luck and keep me informed what you find out.

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how long after the vein surgery before you felt some type of relief on the foot?

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It was the main artery (popliteal artery) which provides all blood flow to the lower leg. I felt about 60% relief right after my artery surgery. My toes were not purple and the foot was not cold. some of the numbness and tingly was gone, but not all of it. That surgeon told me because I went so long without blood flow could have caused permanent damage to cells and tissues. At lease it is a more tolerable numbness and tingling. I still have to wear shoes and socks ALL the time in the house. Summer and winter. I did just see another knee doctor and was told the TKR surgeon put in to small of a spacer and that is causing that knee to give out on me, which it does. If I try to run the leg just flops. But too early (2 years) to go in and do a reconstruction of the spacer since the trauma of the TKR and the artery surgery. Lori A.

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@irol

Yes, when I went to my surgeon for a followup, he would not even let me finish describing my foot problem and interrupted me, saying that it had nothing to do with the knee surgery. (It was incredibly painful and had numbness later as soon as I woke up in the recovery room). I made a special appointment to talk about the foot a few months later and he had me see the PA, not him, and she kept changing the subject and would not address any causes of the foot neuropathy as being connected to the surgery. Have you requested and read all surgery notes? Maybe you should find out how long the tourniquet was on your leg during the surgery. Over 45 minutes can cause nerve damage, I think. Maybe there were other irregularities...although they may not have recorded a problem..

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In the hospital my surgeon knew I have the numb tingling, but never touch or looked at my leg/foot just said that was normal and give it time. Next day same thing, but then said you just bought yourself another day in the hospital. He never too the wrap off or even looked at it, the nurses did it all. PT just put a leg stabler on that leg so I could stand up. I got copies of my medical records. he NEVER put any of the foot info in there. But put surgery took longer than normal because of soft tissue. asked him why, he said he puts that in all surgeries incase you need to be in the hospital longer. I had a HUGE bruise from the tourniquet that didn't notice til I got home and my husband saw it.
He never put notes in chart till months later and weren't approved until I brought it to the attention of the patient advocate at the hospital. He even hi-lighted and deleted my 3 week check up with him when I went back 3 months later and told him what he did to the artery. I took info to lawyer. They said I had a good chance for a good case of neglect. Well since he never put anything about my foot in any of his reports. In fact he had stated in my hospital report he took off the wrap and looked at my knee in the hospital. He blatantly lied on all my visits with him. I had a 2 year appoint with him for Friday 2-5-2021 and cancelled it, he is not with worth wasting my time to have him tell me again it takes time to heal the nerves and give in yet another year or two. That there was nothing he could do. NEVER once has he said I'm sorry that this had to happen, nothing! and that alone would mean a lot to me. All I was ever told was that it was normal, give it time, then why I waited 60 days to get it fixed I could of lost my leg. At one yr appointment "I suppose there will be a law suit. Well I tried since he asked, but when Doctors are allowed to lie and change their medical records you don't have a chance. Lori A.

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