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TKR Numbness in the top of my foot after TKR

2boxers

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Had left TKR done around 4pm Thursday. I had multiple reactions from the anesthesia: Low blood pressure, low body temp (93) and severe nausea. I finally started to stabilize Friday afternoon. I really didn't have much pain around the surgery site, but I did notice the top of my left foot was numb and swollen. I never experienced this numbness with my right TKR (6 years ago).The pain level is really kind of odd ( not that I'm complaining!!) , but I've gone over 8 hours without taking anything and this is only day 3 post op. Is this numbness something I should be concerned about? My leg doesn't feel numb, just the top of my foot...is this why i'm not feeling much pain? Thanks!
 

newlybionic

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Give a call to your OS Office about your foot being numb and swollen. I’m not sure what could cause it. Let me give you your own set of knee recovery articles.


Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

leejaa

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Just a quick hello to see how you are doing and if the top of your foot is still numb. I hope your OS had some suggestions for you. Have a peaceful night.
 
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2boxers

2boxers

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It's been almost 4 weeks post op and my knee is still swollen. My knee is nice and straight but my rom is only 90º. I am constantly icing and elevating, doing PT 3 times a week, and doing my PT exercises at home. I am careful not to over do, but the swelling is taking forever to go down. Any suggestions or insight? I am getting depressed and worried about my lack of progress.
 

Celle

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This is a slow recovery, @2boxers and it's not unusual to still have some swelling at 4 weeks post-op.

Don't worry about your flexion. 90 degrees at 4 weeks is great. Most surgeons don't expect 90 degrees until about 6 weeks, so you're actually ahead of the game.
(By the way, ROM - Range of Motion - consists of both flexion/bending and extension/straightening.)

Have your PT therapists been telling you that you only have a short amount of time in which to gain full ROM? It sure sounds like it - but that isn't true. It's an old myth that should have died long ago.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase, whether you do formal exercises or just let your activities of daily living be your exercise.

I think it would be a good idea to cut back your PT to one or two sessions a week. That's quite enough. 3 sessions a week is really too much and they could be contributing to your knee swelling.

You might find this article interesting:
Knee recovery - Lose the Work Ethic!!

You don't have a lack of progress at all. What you have is impatient PT therapists. They often get a bit obsessed with a quick increase in ROM numbers because it's something positive they can show, to prove how effective their treatment has been. It's not always the best thing for your knee, though.
 
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2boxers

2boxers

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Celle, Thank you for the response. I have been thinking there was something wrong because I just can't get pass 90º due to the swelling. I'll try not to be too hard on myself. I keep telling myself I need give myself time to heal, but this bad knee has made everything difficult since June. I think I am just tired of being gimpy and I feel I will never get my life back. Ok, enough whining, time to get my big girl panties on and be thankful for all that I have. Healing will come, in time.
 

Pumpkln

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@2boxers
You'll notice that I have merged your newest posts with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
 

leejaa

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The one thing you can exercise a lot and we all need to in recovery is patience. Give your knee more rest with ice and elevation and less exercise so that swelling can decrease. Being gimpy for a time before surgery I totally understand as I had a 5m wait and the pre operative pain and limitations really tired me out. My decision was to go very slowly and listen to the knee and my body which needed time to heal and rest. It worked for me with minimal exercises.
 
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2boxers

2boxers

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Thanks Leejaa. You are so right, I need to practice patience. You said you did minimal exercises, what did you do and how often? I've come to realize that if my knee isn't ready, working harder isn't going to bring the results I want. I am going to cancel my PT for today and see if having 4 days off makes a difference in the swelling. I'll continue to do some simple exercises, but none of the intense stuff. Wish me luck!
 

leejaa

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My biggest exercise were ankle pumps and gluteus squeezes and thigh tightening. I would attempt a few and I do mean few 3-5 leg lifts but if my knee said no I would not pursue. I also did heel slides but instead of doing laying down. I would do the ankle pumps a lot when reclining or laying down since it was easy and did not cause pain. I elevated and iced anytime I was reclining or laying down.

My biggest exercise was using my platform rocker for flexion exercises but not forcing it. Rocking can be meditative and relaxing so I would sit there with my leg bent some but not too much and rock as I read or watched TV. If my knee let me I would slide the foot back toward the chair to get more bend as I rocked but not forcing it at all. I also often kept ice on it as I rocked as I had a knee wrap that held my ice packs. I was home alone all day so walked to get drinks, food, bathroom or just to change position as needed so I was not in same position all day. It worked out really well for me.

With my second knee I bought a recumbent exercise bike and after 4-5 wks I would peddle it some with no resistance for 5m at a time. At first it was just moving it back and forth (rocking) till the knee recovered enough to let me go around. I also kept the seat back so it was easy on the flexion and not push it too fast.

Keep listening to your knee and your body. It takes a lot of energy to get through recovery as our bodies have gone through a major surgery and both our bodies and our knees need time to heal and recover. :flwrysmile:
 

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