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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Navyqas I had TKR 2yrs 4mons ago and have had nerve pain since. My pain is mainly just below knee but do have some numbness in bottom of foot. 9mons ago I tried a revision with different doctor, he made no promises, and have had no change. New doctor thinks tourniquet during 1st surgery was on to long but no way of knowing. Nerve pain or damage seems quite common with TKR but no doctor says this. My search continues because I can’t accept nothing can be done. Maybe I am wrong but I will keep searching. Best of luck

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@sprinrosa64

Navyqas I had TKR 2yrs 4mons ago and have had nerve pain since. My pain is mainly just below knee but do have some numbness in bottom of foot. 9mons ago I tried a revision with different doctor, he made no promises, and have had no change. New doctor thinks tourniquet during 1st surgery was on to long but no way of knowing. Nerve pain or damage seems quite common with TKR but no doctor says this. My search continues because I can’t accept nothing can be done. Maybe I am wrong but I will keep searching. Best of luck

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Hi 64
My surgeon did not like the fact that I took the bandages off in two days, he said I told you three days! I took the damn bandage off a day early because it was so tight my leg turned purple and the pressure was unbearable. I think the fact that I had NO foot numbness or discoloration for the first 10 hours after the operation speaks volumes as to the extreme pressure he applied. So your new doctor confirms my thinking about nerve damage could have been done by overly constricting a nerve. Also the TKR took two times longer then he said it would, why? who knows, he was working on another person at the same time in another room, that I know for sure. So again the tourniquet time your doctor brought up very well could have applied to me also. Thank you much and I wish the best for your leg

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@sprinrosa64 My surgeon did 8 TKR the day I had mine done so who knows how long a tourniquet was left on. I had a huge black and blue at the top of my thigh. He worked on as least 2 if not 3 at a time. never talked to my husband when he was done and I only saw in the 3rd and 4th day in the hospital for maybe 5 min. he never looked at the leg or touch it. he never came closer than 5 feet from the end of the bed and just kept saying the numbness and tingling was normal. Didn't find out till 6 weeks later when my primary ordered an ABI test which showed low pressure in that leg and angiogram showed the popliteal artery was pinched shut. That is what caused the foot to be numb, tingly, cold with purple toes. When artery was opened (another surgery) it gave me half relief for numb and tingling and total relief for cold foot and toes were not purple. I went back to him and told him what he did and all he said was "why did you wait so long to get it fixed, you could have lost your leg"
good luck and wish you all the best with your TKR issues.

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@navyqas

Hi 64
My surgeon did not like the fact that I took the bandages off in two days, he said I told you three days! I took the damn bandage off a day early because it was so tight my leg turned purple and the pressure was unbearable. I think the fact that I had NO foot numbness or discoloration for the first 10 hours after the operation speaks volumes as to the extreme pressure he applied. So your new doctor confirms my thinking about nerve damage could have been done by overly constricting a nerve. Also the TKR took two times longer then he said it would, why? who knows, he was working on another person at the same time in another room, that I know for sure. So again the tourniquet time your doctor brought up very well could have applied to me also. Thank you much and I wish the best for your leg

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I had ACL replacement/MCL repair, not TKR, and suffered numbness for more than a year afterward. It was bad enough that I could not walk on any uneven surface without watching my foot, lest I trip & fall. Sometime between 18-20 months, it got better. It took the nerve damaged during surgery that long to regenerate, and I was only 44 years old at the time. Fast forward 16 years, and I had numbness down the side of my leg after revision of a total hip replacement. That extended from thigh to mid-calf, and was mainly annoying, but I would find myself with cuts, bruises or scrapes I never felt – it took nearly 3 years to resolve.
My ortho says nerve regeneration is notoriously slow and uncertain in anyone with other circulatory issues.
Sue

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@sueinmn

I had ACL replacement/MCL repair, not TKR, and suffered numbness for more than a year afterward. It was bad enough that I could not walk on any uneven surface without watching my foot, lest I trip & fall. Sometime between 18-20 months, it got better. It took the nerve damaged during surgery that long to regenerate, and I was only 44 years old at the time. Fast forward 16 years, and I had numbness down the side of my leg after revision of a total hip replacement. That extended from thigh to mid-calf, and was mainly annoying, but I would find myself with cuts, bruises or scrapes I never felt – it took nearly 3 years to resolve.
My ortho says nerve regeneration is notoriously slow and uncertain in anyone with other circulatory issues.
Sue

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Hi Sue
Good conformation info on repair/time for nerve damage, makes one have some hope. I think you were the first to have good news on nerve repair after such a long time, that I have read about. Thank you Mike

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@navyqas

Hi Sue
Good conformation info on repair/time for nerve damage, makes one have some hope. I think you were the first to have good news on nerve repair after such a long time, that I have read about. Thank you Mike

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I had my second total knee in December 2020. My foot has been numb ever since and at times it actually is cold and at other times it’s warm but my brain registers it as cold and I’ve found very little I can do so that my brain sees it as warm. I’m miserable at times. Other times it slightly feels asleep. I’ve been working with a spine dr who has given me injections and burnt the nerves. We have been working together since sciatic issues with my first total knee in 2018. Oddly enough, I’ve found putting a heating pad under my thigh on that leg, right up right to bend in my knee, will in time give me a warm sensation in my knee. It’s excruciating to get to this point and it doesn’t last. I’m on gabapentin. Hard to know if it works but I’m afraid of what the pain could be like without it. Recently I’ve stumbled on the reality that I have a pinch nerve under my knee and when the pain there gets a bit worse, my foot feels more numb. So sciatic nerve in this size comes into play as well as all these other things. Orthopedist says he can find nothing wrong under my knee. Stabbing pain! I don’t know what to do or who else to turn to! Think I’m going to ask to be referred to neurologist. If anyone has suggestions, please I’m miserable and desperate. I just turned 57 and I want my life back!

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@navyqas

I have a general question, after my TKR (when I woke up) I felt little pins and needles in the toes, not much and NOTHING else, after approx. 8 TO 12 HOURS, the bottom of my foot had numbness (approx. 50%, heel area mostly) my bandage was VERY SUPER tight, my leg became black and blue, I was told the bandage was to remain for three days. Question: Could bandage OVER compression cause foot numbness after TKR? I ask because, why did it take 12 hours for the bottom of foot to get numb? If the surgeon damaged a nerve during the operation wouldn't the heel numbness start immediately? The foot has been the same numbness as it was after 12 hours for a year now.
Anybody else have the VERY tight bandage and numb foot HOURS and HOURS AFTER the surgery? And more important, did it ever get better? I will resist ever having TKR on the other knee with every fiber in my body!

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My tkr was in 2018 and I had my second in dev. 2020. First time around I woke up with compression stockings on, second time I work with an ace bandage from ankle to thigh and it was not right at all. I wondered why no compression stocking as this helps with blood clots. I don’t believe bandage should be so tight as to cause you to be black and blue or for you to lose feeling and be numb….. the foot numbness I’m dealing with from this second tkr sounds a little bit like what your experiencing. Neuropathy. Possibly orthopedist would refer you to someone who can get you on gabapentin or lyrics or something else for nerve pain if they feel this is what's happening. I find I have to get in a hot shower, the hottest I can stand and let it hit my foot and leg. I do get a little bit of relief. I do this mostly at night when I need to sleep. Or I sit in recliner with legs raised to just below my heart and I turn in the tv to take my mind off the sensations. I’ll do this until I’m exhausted and sleep right there turning to off.

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@sdhkkjmz

I had my second total knee in December 2020. My foot has been numb ever since and at times it actually is cold and at other times it’s warm but my brain registers it as cold and I’ve found very little I can do so that my brain sees it as warm. I’m miserable at times. Other times it slightly feels asleep. I’ve been working with a spine dr who has given me injections and burnt the nerves. We have been working together since sciatic issues with my first total knee in 2018. Oddly enough, I’ve found putting a heating pad under my thigh on that leg, right up right to bend in my knee, will in time give me a warm sensation in my knee. It’s excruciating to get to this point and it doesn’t last. I’m on gabapentin. Hard to know if it works but I’m afraid of what the pain could be like without it. Recently I’ve stumbled on the reality that I have a pinch nerve under my knee and when the pain there gets a bit worse, my foot feels more numb. So sciatic nerve in this size comes into play as well as all these other things. Orthopedist says he can find nothing wrong under my knee. Stabbing pain! I don’t know what to do or who else to turn to! Think I’m going to ask to be referred to neurologist. If anyone has suggestions, please I’m miserable and desperate. I just turned 57 and I want my life back!

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I think you are on the right track to ask for a neurology consult. You may find out it will be a waiting game for the nerve to regenerate, or they may find a different problem, but in any case you'll have an answer. For what it's worth, my sister-in-law had 2 partial knee replacements, 8 weeks apart in 2019, and one was fine, but the other gave her nerve pain that persisted into the fall of 2020 – the neurologist tested & determined it will eventually heal. The pain is gone, but the doc says she may always have some numbness on that foot.
Sue

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@sdhkkjmz

I had my second total knee in December 2020. My foot has been numb ever since and at times it actually is cold and at other times it’s warm but my brain registers it as cold and I’ve found very little I can do so that my brain sees it as warm. I’m miserable at times. Other times it slightly feels asleep. I’ve been working with a spine dr who has given me injections and burnt the nerves. We have been working together since sciatic issues with my first total knee in 2018. Oddly enough, I’ve found putting a heating pad under my thigh on that leg, right up right to bend in my knee, will in time give me a warm sensation in my knee. It’s excruciating to get to this point and it doesn’t last. I’m on gabapentin. Hard to know if it works but I’m afraid of what the pain could be like without it. Recently I’ve stumbled on the reality that I have a pinch nerve under my knee and when the pain there gets a bit worse, my foot feels more numb. So sciatic nerve in this size comes into play as well as all these other things. Orthopedist says he can find nothing wrong under my knee. Stabbing pain! I don’t know what to do or who else to turn to! Think I’m going to ask to be referred to neurologist. If anyone has suggestions, please I’m miserable and desperate. I just turned 57 and I want my life back!

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Ask for an ABI test (blood pressure of your leg) that is how they found low pressure in my leg. Then a had angiogram that found the popliteal artery behind my knee was totally pinched shut. I had the cold feeling foot but foot was warm. Sometimes toes were purple and/or white along with Numbness and tingling on bottom of foot some days worse than other.
Opening the artery by surgery helped 50%. I’ve had nerve testing they said was from my spine but never had these problems before my TKR. Woke up after surgery with totally asleep foot. Foot hurt worse than knee. Keep asking questions and be an advocate for yourself. It took my primary and 60 days before I got it fixed. TKR doc said all the numbness and tingling was normal. It wasn’t. His response was “why did you wait so long you could of lost your leg”.

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@sueinmn

I think you are on the right track to ask for a neurology consult. You may find out it will be a waiting game for the nerve to regenerate, or they may find a different problem, but in any case you'll have an answer. For what it's worth, my sister-in-law had 2 partial knee replacements, 8 weeks apart in 2019, and one was fine, but the other gave her nerve pain that persisted into the fall of 2020 – the neurologist tested & determined it will eventually heal. The pain is gone, but the doc says she may always have some numbness on that foot.
Sue

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Ask for an ABI test. See some of my other posts. My popliteal artery was pinched shut during my TKR and had a totally numb tingly foot after surgery. Good luck

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