Had anyone had nerve ablation for post op TKR pain?

I had a radio frequency ablation for a pinched nerves in my right lumbar back. That was about a year and a half ago. None of the pain on that side has come back. I had several steps I had to complete before the actual ablation. Physical therapy was first, then the neurologist/aesthesiologist made a "map" for the nerves that were going to "fried". ouch! that sounds bad. The doctor also had a screen that displayed the layout of the nerves during the procedures. I have a fuzzy memory about some this. This all took several months. Then he did the ablation. Most of the nerves had a small burn feeling as he zapped them. For several of the nerves I felt nothing at all. I asked him whether these nerves had been deadened by the arthritis and bone spurs. He replied that if that was the case, theoretically, I wouldn't feel pain in the first place. But I think they were deadened by the arthritis and I felt pain from the remaining nerves.

Yes, Ive had several knee ablations post-TKR. They are painful but you can drive after. I have to admit that they only helped me with about 30% of my pain for a couple of months- no where close to 6 months. After 4 per knee I have taken a break to see if I notice a big difference. They dont help with the tightness I have (24/7) . They help a bit with the sharp pain I have when walking. Not sure yet if I will try again.

So, reading between the lines, it appears that knee injections of steroids and/or hyaluronic acid would do you no good in terms of alleviating pain? Or did you jump to knee ablations first? I have a spot on one knee that is bone on bone and it gives me sharp jabs of pain fairly often. Recent series of 3 HLA injections have helped but I know the good effect will not last long, so I'm wondering if there is a nerve treatment (ablation) that would help. I have not had a TKR, just arthroscopic procedure in April of this year. How do you talk the ortho doctors into giving nerve ablations? Are there limits as to some certain condition must first exist before the ortho doctors will go forward with the ablation?

I have not had an ablation before TKR so I really cant answer your question. I went right from HLA to Synvisc to replacement. I think the thing to be wary of is talking your surgeons into anything. In my experience this is their profession. Its what they do. if they think you need it, get on a list and, even then, think twice. A certain percentage of TKRs fail. Mine are painful every day. No quality of life. Sure I can bend them but I still cant walk for more than a block or two without sharp pain.

I read on several sources that around 750,00 TKR’s are done yearly in the U.S.
Success was mentioned as 85-90%. So even at a generous 90%, that means about 10% (75,000) are not successful. But I haven’t read criteria used to
determine that. I am at ten months with daytime comfort, but night pain
preventing much sleep. I hope this is not predictive. And I do daily exercises.

@andid
Did the doctors ever discuss a partial knee replacement with you instead of a TKR?

@laughlin1947 Yes, that was the original plan. Even though I had told him the entire year pre-surgery, and it was typed on all of my hospital docs, he forgot I was allergic to nickel and one week before my surgery he told me we would have to either do a full TKR with Titanium or nothing at all. I opted for full. Wish I hadn't.

@laughlin1947 Yes, but when he said I would eventually probably need a TKR, I opted to just go ahead and do the total. Don't regret it.

@lynnn

The definition of unsuccessful mostly includes people who are not satisfied with the feeling of the implant or the mechanics of it compared to their expectations.

I was severely misaligned and bone on bone. My surgeon did discuss with me doing a partial but he determined that my arthritis was too bad on all surfaces. So he did a total which even included doing a patelloplasty. I wanted a bicruciate retaining implant if my ACL was strong enough and my surgeon who is vastly experienced doing that agreed. it turned out that despite my "severe fixed contracture and valgus" he was able to both do a BCR (Journey II XR) and fix my alignment with a functional alignment.

I came out of it with only pain when I first stood up and started walking (with a walker as my surgeon insisted that I use one my first week) and some soreness around the muscles above the knee. After about 20 feet the pain from my incision area mostly abated.

So...it is possible to have a TKR, even a complex one, without substantial pain. Most of it depends upon finding and using an incredibly skilled surgeon (great mind, great hands) but some of it does depend upon pure luck. Feces does sometimes just happen.

I have stenosis in my spine. For years it was non symptomatic. Then at the beginning of 2025 it became symptomatic with pain radiating down my legs. My pain doctor gave me a steroid shot (caudal, epidural) and my pain is in abeyance (right now). On the other hand, I had severe paid on my right leg (my surgical leg) when I stepped the wrong way on my heel. A nerve impingement from the knee I determined (with the help of my pain doctor, my knee surgeon, and my foot/ankle surgeon). My surgeon gave me a steroid shot in the knee and it did nothing. But after my knee surgeon replaced my knee and did the functional alignment, the pain disappeared (12 days ago).

My only thought would be to see a good neurosurgeon. When my Neurologist first sent me to a neurosurgeon for an opinion, the neurosurgeon put me on what he termed a watchful waiting list of about a hundred patients. He is/was top rated and very busy doing minimally invasive surgeries (he wrote the primer on it) so he has no need to rush people into surgery. Look for a neurosurgeon like that and see if you can get an appointment. No one understands nerves like a good neurosurgeon.

Sorry there's a lot here!!! I had my right TKR 8 years ago and my left 7.5 years ago. After recovery I returned back to most of my normal activities. Going forward now 2 years I was feeling some aches and pains around my TKR's, but mostly my right knee. He recommended PT. I did a few sessions without any results. He referred me for aqua therapy. Nothing. People think about swimming and bike riding being the best exercise, I found them to be the biggest cause of my problem. Jumping ahead 3 years, Feb 2022 I had left THR. 6 weeks into my stellar top of the class recovery, I had a slight mis-step and sent my hip/lower back into a total out of whack dysfunction. While dealing with that my right knee was just going thru lots of pain and discomfort, trying to favor the left leg. I visited with my surgeon, he made me feel warm and fuzzy by first telling me he is no longer doing knee replacements. He gave me a sleeve and told me to use diclofinac gel. So now I have 2 issues to take care of.=, ugh!!! At this time I also turned 65 so I was now in the world of Medicare. Gave me the opportunity to make some changes. Booted out everyone and started new. Over the next 2 years I visited with knee surgeons, nope nothing!!! 3rd time was the charm. The new dr (new best friend) said that it feels like the bands holding things together weren't strong enough. He gave me a Don Joy Reaction knee brace. The 1st time using it while swimming, besides being a bit cumbersome, worked fantastic!!! At my next PT visit I ask the therapist if there's something more comfortable for me to use. We tried K-Tape. It was a miracle!!! I have been now using the K-Tape for a year and no more aches. I have gone on 3 trips (min 18 days) since then I bring a supply of K-Tape (I buy the bulk and cut myself) along with alcohol wipes (to clean the area). The great thing is the K-Tape can last 5 days, even after pool, sauna, jacuzzi, showers, and bike riding. The biggest enemy is wearing long pants, but in SoCal, that doesn't happen often. If you are going to PT, ask the therapist if you could try the K-Tape and see what happens. It can't hurt??? There maybe be some skin irritation, so you may have to try different brands, I use Theraband products. Amazon has some good deals. I wish you lot of luck!!!! BTW with a pain specialist I did try RF ablation on my knee, it was really quick and very painful (blazing hot). No local. Just a couple of Tylenol.