Foot Numbness After Knee Replacement: Causes and What to Expect
Foot numbness after total knee arthroplasty (TKA) is relatively common and usually transient. Potential causes:
- Peripheral Nerve Injury: Stretch/compression of the common peroneal nerve (at fibular head) or saphenous nerve during surgery or positioning.
- Nerve Block Effects: Femoral or fascia-iliaca blocks can cause temporary foot numbness (especially saphenous distribution) lasting hours to days.
- Postoperative Edema: Swelling in the calf/ankle compresses nerves (e.g., tibial nerve at tarsal tunnel, peroneal at fibular head).
- Positioning: Prolonged lithotomy or lateral rotation during surgery may stretch the sciatic/peroneal nerves.
- Pre-existing Neuropathy: Diabetic or compressive neuropathy unmasked by surgery.
When to Notify Your Surgeon
Report persistent (>2–3 weeks), worsening, or progressive numbness, weakness (foot drop), or pain. Evaluation may include neurologic exam, EMG/NCS, or imaging.
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