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Numb foot after TKR
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Numb foot after TKR

Hello,
I had an EMG and Nerve test. 14 weeks ago I had a Total knee revision and right after surgery woke up in the recovery room with a numb foot. The surgeon was not concerned and said it would go away. He has told me to be patient and give the nerve time to heal. It could take up to 16 months. I currently still have to walk with a crutch and the more I am on the leg my foot gets the sensation that feels like something is strangling the foot. The bottom of the foot also feels like I have a huge lump when I walk. I don't it just feels this way. Also the  more I exercise the knee the worse the foot gets. I can not put anything on the foot, such as a sock or shoes. I currently can only wear slip on beach sandals that have gel padding. The bottom of my foot is also very sensitive and I cannot really bend my toes. Here are3 my test resluts.

ELECTRODIAGNOSTIC FINDINGS:
Low amplitude with normal latency in the left peroneal motor nerve conduction study.
Borderline low amplitude with normal latency in the left tibial motor nerve conduction study.
Low amplitude wit normal latency in the left sural sensory nerve conduction study.
No response in the left superficial peroneal sensory nerve conduction study.
Normal right sural and superficial peroneal sensory nerve conduction studies.
Needle EMG findings in the left lower limb as in the chart below.

ELECTRODIAGNOSTIC IMPRESSION: Abnormal study. Today’s electrodiagnostic evaluation is consistent with the following:
Incomplete axonal sciatic neuropathy affecting both peroneal and tibial divisions located somewhere between the branch points to the short and long heads of the biceps femoris.

All EMG findings in affected muscles are acute and would fit the time frame of the onset of her clinical symptoms

Thank you for any information and thoughts you have.
Avatar_dr_m_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

The symptoms you are describing are consistent with a sensorimotor neuropathy, meaning that both the sensation and motor nerves have been affected. Although I have not done the EMG, the impression supports this finding too.

Patients with neuropathy often have symptoms of hypersensitivity, pain, numbness, tight band sensation in the affected areas.  

This neuropathy followed your TKR so it is possible the nerve was injured at some point during the surgery. The EMG notes that it is an “axonal” neuropathy. An axon is a nerve fiber which carries signal to and fro from the foot to the spinal cord. When an an axon is damaged, it can take a long time to heal.

What can help during this period is physical therapy and use of braces/supportive materials if you have anything like a foot drop. Also certain medications like gabapentin are good for pain/discomfort from neuropathic causes. I would recommend seeing a neurologist and getting physical therapy for that leg.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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