Why do I have a numb foot post-op

[Nurse Rachett]

I recently, August 20th, had a total left knee replacement for osteoarthritis. I am 57 years old. I have done very well except the bottom of my left foot has been "numb" since surgery. I woke up in the recovery room with this. Between my toes and the top of my foot is normal. The tips of my toes and the bottom of my foot is not completely numb but feels as if I have a thick layer of callus. I have pain in the end of my great toe and occasional sharp, shooting pains in the arch of my left foot. My orthopedic MD says he never goes near the sciatic nerve during a knee replacement but this seems very much like the nerve is damaged. I know it branches at the ankle. I did have a spinal but as the anesthesiologist noted, if the nerve had been damaged by the spinal, it would be bilateral.
Have you got any ideas? The ortho MD thinks this will subside but so far it has stayed the same. My toes curl under and my foot feels cold but circulation is good with all pulses strong.
I would greatly appreciate some help.
Cheryl Langford

[MyBellyHurts]

You need to see a neurologist to have your perrinial (sp?) nerve checked. It's in the side of the knee and when it is pinched, it causes you to lose all feeling in your foot. For your $15.00 here, you get one response from the doctor. Once they answer, they do not go back and read the post they answered.

[Nurse Rachett]

I had to pay, with credit card, a $15.00 fee to post a question. How do you do it for free?
No answers will be fine.

[Kayano]

Don't know what you are paying $15.00 for but I belong to the community and ask questions for free all the time. I don't belong and one doesn't have to be a paying member to get questions answered.  When I signed up, the disclaimer stated it could take "up to a week" to receive and answer to your question as there are so many people. However, with the tone of your current question regarding "pat answers", I truly doubt you will get any answer now.

[Nurse Rachett]

Do we not get an answer to our questions? Or, do we just get pat answers for our first $15.00?

[Nurse Rachett]

Thank you for your reply.
Yes, I am aware that the sciatic nerve is not normally involved with this procedure but, my question is to you-could it have been damaged by equipment used, etc. Are there any other nerves that affect that area of the foot-bottom and tips of toes?
How could I have damaged disc in a few short hours of surgery? My foot was fine prior to being put to sleep.I had an MRI of my total spine just two years ago and there were no bulging discs and I have had no problems with my back or pain down my legs. I awoke from surgery with this problem and cannot get any anwers from anyone.
Have you ever had an EMG? I have had EMG's-extensive, from my neck down and they are horrible. I am sure that it will show nerve damage. But, I think a numb foot is a pretty positive notion that there is nerve damage!!! Why go through all that pain and expense with another EMG?
What I want to know is, with the nerve damage that the area on my foot reveals, where is the most likely point of injury and what if anything could be done to help with the discomfort.
Thank you,
Cheryl Langford

[Kevin Pho, MD]

Nerve damage is possible, however I agree with the surgeon that the sciatic nerve normally isn't involved with the procedure.  

Further evaluation of the peripheral nerves should be done.  A nerve conduction or EMG would be a reasonable initial test.  If there are positive findings, a lumbar MRI can be done to determine if there is a herniated disc or pinched nerve.

A neurology referral should be obtained to evaluate these symptoms.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_