Pain and numbness in the leg, ankle or foot following a total knee replacement is a somewhat rare, but serious complication of total knee replacement (TKA). Many patients are told this is a self-resolving problem that will get better over time. Unfortunately, this is not true in too many cases. Symptoms that persist several weeks or months after total knee replacement will generally not get better without surgical intervention.
The Common Peroneal (Fibular) nerve, a branch of the Sciatic nerve that courses from the knee over the top of the fibula bone, is almost always the nerve affected in a total knee replacement. This nerve is particularly susceptible to injury or compression, either by scar tissue, swelling, or other cases, where it is more superficial above the fibula on the outside of the leg. Peroneal neuropathy can lead to decreased sensation over the top of the foot and ankle and loss of motor function, commonly referred to as a foot-drop, where the patient has trouble flexing the foot upwards. Pain associated with a peroneal nerve injury can be even more problematic for the patient than the loss of sensation and/or motor impairment.
Patients with diabetes or rheumatoid arthritis may be at a higher risk for this complication of total knee replacement. Certain factors in surgery, such as prolonged tourniquet use, may also increase the risk of developing neuropathic complications.
In some cases, these symptoms may be resolved through simple measures, such as relieving any external compression to the area around the nerve. However, if symptoms have not resolved or have only partially resolved within 3 months post-operatively, surgical decompression of the nerve is often necessary.
Following a nerve decompression, there is a very good chance for improvement in sensation, reduction in pain, and return of motor strength. Peroneal nerve decompression is a quick procedure and most patients are back to normal activities within a few days of surgery.
The experts at US Neuropathy Centers have been extensively trained in Peroneal nerve decompression and other nerve decompression surgeries. If you have prolonged symptoms of neuropathy following a knee replacement, don’t wait for the symptoms to just “get better,” especially if the relief is only partial. Take charge of your health by contacting one of our specialists today!
The advice and information contained in this article is for educational purposes only, and is not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational medical material.
@US Neuropathy Centers, 2018