Tarsal Tunnel Syndrome Following a Total Knee Replacement

Tarsal tunnel syndrome (TTS) is defined as an entrapment neuropathy from compression of the tibial nerve and/or distal terminal nerves in the tarsal tunnel, the medial foot, and/or ankle. While the incidence of TTS following a total knee replacement (TKR) could not be found, we present the case of a 78-year-old white female who developed symptoms of TTS 2 weeks after a left knee replacement. The history, examination, imaging, and electrodiagnostic (EDX) studies were consistent with the diagnosis of left-sided TTS. After a course of conservative care failed to alleviate her symptoms, the patient underwent nerve decompression surgery for the affected nerves. Her pain score prior to the surgery was 5 out of 10 when walking, and 10 out of 10 at night. Immediately after surgery, her pain at its worst was 3 out of 10, and soon thereafter she reported no pain whatsoever (0 out of 10). All TTS-related symptoms subsequently resolved. This case presents an unusual extrinsic cause of TTS, highlights the need for a thorough history when diagnosing TTS, and contributes to the scientific community's knowledge of knee complications and possible etiologies of TTS.