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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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vinran | @vinran | Apr 27, 2022
In reply to @johnbishop "Hello @vinran, Welcome to Connect. I'm not very fond of the term idiopathic either which is..." + (show)
@johnbishop

Hello @vinran, Welcome to Connect. I'm not very fond of the term idiopathic either which is my neuropathy diagnosis. I know all surgeries carry a risk and nerve damage is one I was worried about when I had my right knee replacement done. I also had lymphedema prior to the surgery and have to wear compression socks to keep the swelling down. Here's some information I found that talks about what I think you are describing.

"Can knee surgery cause swollen lymph nodes?
The secondary form may be caused by a lesion of the lymphatic vessels and/or lymph nodes during diagnostic or therapeutic procedures such as surgical interventions. Often, in clinical practice, there is lymphedema after orthopedic surgery, even in minor orthopedic surgery."
-- Lymphatic edema of the lower limbs after orthopedic surgery: results of a randomized, open-label clinical trial with a new extended-release preparation: https://pubmed.ncbi.nlm.nih.gov/26753640/

Hopefully your next appointment can provide some answers for you. Can you provide an update after your appointment next week with the general surgeon?

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Sorry, spellcheck,
Meant to say “and appreciate the information” …

REPLY
vinran | @vinran | May 4, 2022
In reply to @vinran "I developed foot neuropathy about 6 mont(s after TKR, never had symptoms prior to surgery. I’ve..." + (show)
@vinran

I developed foot neuropathy about 6 mont(s after TKR, never had symptoms prior to surgery. I’ve seen neurologists, a vein surgeon,had an ECG and an
ultra-sound and doctors say everything is fine, but it isn’t. I’ve been prescribed Gabapentin which helps me sleep at night. Most neuropathy symptoms do appear late in the day or early evening. Symptoms are tingling in the bottom of my feet and a burning sensation. I’ve also Devoloped lymph node swelling at the top of my surgery leg in the groin area. Tests results indicate lymph node swelling but appear to be no abnormalities. I’m tired of the term “ideopathetic from all doctors I’ve seen. I am now referred to a general surgeon next week to assess my nymph lobe swelling. Disgusted here. Knee itself has been okay from a functional standpoint.

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Saw a surgeon
He did a thorough exam and can’t find anything
that would be obvious to the cause of my groin lymph
swelling. He believes it is a result of the extensive TKR
I had and may take 2-3 years for the fluids etc in my leg to return to normal - I didn’t quite understand all of that but wants to have another ultra sound in 6 months and see where I am at.
That’s where I am at.
I mentioned the foot neuropathy issue as well and he said that’s not abnormal and may eventycorrect itself.
We will see

REPLY
1 reply
vinran | @vinran | May 4, 2022
In reply to @vinran "Saw a surgeon He did a thorough exam and can’t find anything that would be obvious..." + (show)
@vinran

Saw a surgeon
He did a thorough exam and can’t find anything
that would be obvious to the cause of my groin lymph
swelling. He believes it is a result of the extensive TKR
I had and may take 2-3 years for the fluids etc in my leg to return to normal - I didn’t quite understand all of that but wants to have another ultra sound in 6 months and see where I am at.
That’s where I am at.
I mentioned the foot neuropathy issue as well and he said that’s not abnormal and may eventycorrect itself.
We will see

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Eventually correct itself.

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rjstroebel | @rjstroebel | Jul 28, 2022

I too am 10 weeks post TKR and have this exact same PAIN..At times it's level 8.. elevating doesn't help. The goddamn anesthesiologist and nurse tightend a 3 inch dtrap tornicit on my upper thigh to keep blood flow low so joint doesnt get blood in it during the bone cutting i the moment the nerve block wore off i felt the burning throbbing in foot....10 weeks out I can't wear a sock or sandle on the foot.
Christ...everytime I have a F***** surgery there's a secondary injury that's worse pain than before...
Anyone thinking of having a knee replacement you are NUTS... don't BELIEVE A F****** word your ortho tells you

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westcom | @westcom | Jul 29, 2022

Thank you for comments on side effects of TKR. I had a left TKR in December. At 12 weeks, despite recovery with good flexion and extension and no knee pain) I developed knee weakness ( feels like it is going to buckle when I walk) that has continued. I need to use a cane outside my home for stability. My Ortho says it is not from the TKR but another specialist suggested it could be nerve damage from surgery and has ordered an EMG to determine if localized or coming from my back. Has anyone else experienced this after TKR?

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Jul 31, 2022
In reply to @westcom "Thank you for comments on side effects of TKR. I had a left TKR in December...." + (show)
@westcom

Thank you for comments on side effects of TKR. I had a left TKR in December. At 12 weeks, despite recovery with good flexion and extension and no knee pain) I developed knee weakness ( feels like it is going to buckle when I walk) that has continued. I need to use a cane outside my home for stability. My Ortho says it is not from the TKR but another specialist suggested it could be nerve damage from surgery and has ordered an EMG to determine if localized or coming from my back. Has anyone else experienced this after TKR?

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I had a traumatic knee injury almost 30 years ago, followed by ACL/MCL surgery. For a long time (over 2 years) I experienced the feelings of not knowing where my foot was (it was not numb), a weak feeling (though tests showed the leg was very strong from devoted PT) and occasional pins and needles along the shin. Gradually each of these disappeared.
Fast forward to 2019/2020 - after many more surgeries, arthritis & illnesses, I was in serious chronic pain and referred for pain management & treatment. My PT explained the mechanism of nerve injury & regeneration and gave me reading material.
Wow! All of that old issue suddenly made sense - the badly insulted nerves in my knee had to regrow, and it took over 2 years.

So, you are less than a 9 months from serious surgery - it is quite possible the nerves are still irritated and healing/regenerating. Please do not be discouraged of the EMG comes back with little explanation. Just continue therapy, patience and safety precautions, and let your body heal.
Sue

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1 reply
ammaw52 | @ammaw52 | Aug 7, 2022

Hi since my TKR on my left knee. My left foot has been numb. At times I can't stand a sock on it even. It has been 6 months. I go to a new Dr thursday and hopefully he can answer a lot of my questions about problems I am having.

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1 reply
bowleg2pain | @bowleg2pain | Aug 19, 2022

12 weeks ago I had a MAKO Total knee replacement that corrected 9 degrees of a 14 degree curve in my leg changing the shape of my leg after 52 years. I am now have extreme pain in the bottom of my foot along with severe back and body pain. I am still going to PT 2xs a week and getting stronger but i feel physically worse that before surgery. I am waiting for my other knee to be fixed and hoping it fixes my back and body but what about my feet? does anyone have a similar story or tips on how to relieve pain in feet?

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4 replies
Mentor
Sue, Volunteer Mentor | @sueinmn | Aug 19, 2022
In reply to @bowleg2pain "12 weeks ago I had a MAKO Total knee replacement that corrected 9 degrees of a..." + (show)
@bowleg2pain

12 weeks ago I had a MAKO Total knee replacement that corrected 9 degrees of a 14 degree curve in my leg changing the shape of my leg after 52 years. I am now have extreme pain in the bottom of my foot along with severe back and body pain. I am still going to PT 2xs a week and getting stronger but i feel physically worse that before surgery. I am waiting for my other knee to be fixed and hoping it fixes my back and body but what about my feet? does anyone have a similar story or tips on how to relieve pain in feet?

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When a drastic correction to the limb has been made, retraining of the muscles and ligaments is part of the solution. Your body has spent many years compensating for misalignment, length difference and everything else. Suddenly, BOOM - a huge change to your body. This requires total reassessment of the way the legs, hips, feet & back all work together by a skilled PT. "Typical" post TKR PT will not do the trick! This is a role for a rehab specialist - the person who treats people after limb loss and similar drastic changes.

If the second surgery is coming very soon, you may want to wait for help, but if you are miserable, maybe get the initial evaluation now? Have you had an evaluation of gait and posture after surgery? You may also need new shoes (the old ones all have your pre-surgery wear patterns) and possibly orthotics.

Sue

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Moderator
Amanda Roe | @amandajro | Aug 20, 2022
In reply to @bowleg2pain "12 weeks ago I had a MAKO Total knee replacement that corrected 9 degrees of a..." + (show)
@bowleg2pain

12 weeks ago I had a MAKO Total knee replacement that corrected 9 degrees of a 14 degree curve in my leg changing the shape of my leg after 52 years. I am now have extreme pain in the bottom of my foot along with severe back and body pain. I am still going to PT 2xs a week and getting stronger but i feel physically worse that before surgery. I am waiting for my other knee to be fixed and hoping it fixes my back and body but what about my feet? does anyone have a similar story or tips on how to relieve pain in feet?

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Hello @bowleg2pain and welcome to Mayo Clinic Connect. I see that @sueinmn has joined you and given you some really helpful and practical advice so will let you go ahead and respond to her to allow she and I to learn a bit more.

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