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Dr. Andrew Rynne

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Recovering Alcoholic, Have Alcoholic Neuropathy. Is There A Medical Conflict Between Neuropathy And Knee Replacement?

My Dad is a recovering alcoholic (sober: 5mos). He quit drinking after a diagnosis of alcoholic neuropathy. That has been improving each month during sobriety. Now he would like to get his knee replaced. Is there a medical conflict at all to neuropathy and a knee replacement? Secondly, will his rehab be more difficult this time around because he has some neuropathy? Extra info: he can walk on his own, albeit carefully.
Sat, 3 May 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, Sorry to hear about your dad's neuropathy.
Two things I did not get from your mail are, has any quantitative neuropathic testing been done on his legs and feet in particular? And how is his vision and general balance?
Both these are relevant as severe neuropathy to the point of Charcot's arthropathy can cause the knee replacement to fail prematurely, if joint perception if lost significantly. Second factor determining the longevity of the prosthesis is the bone quality. It again takes a big hit if your dad had been on alcohol for long. In addition vision and gait co-ordination is important for longevity of the replacement. Infection is generally not an issue with ex-alcoholism but neuropathy especially in the feet needs careful patient counselling with respect to possible foot ulceration and subsequent implications on an existing prosthesis.

I hope this helps,
Please let me know if you have any other queries

Dr Purushottam Reddy Padala MS(Ortho) FRCS
Consultant orthopaedic and joint replacement surgeon.
Happy joints orthopaedics
Hyderabad.India
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Recovering Alcoholic, Have Alcoholic Neuropathy. Is There A Medical Conflict Between Neuropathy And Knee Replacement?

Hi, Sorry to hear about your dad s neuropathy. Two things I did not get from your mail are, has any quantitative neuropathic testing been done on his legs and feet in particular? And how is his vision and general balance? Both these are relevant as severe neuropathy to the point of Charcot s arthropathy can cause the knee replacement to fail prematurely, if joint perception if lost significantly. Second factor determining the longevity of the prosthesis is the bone quality. It again takes a big hit if your dad had been on alcohol for long. In addition vision and gait co-ordination is important for longevity of the replacement. Infection is generally not an issue with ex-alcoholism but neuropathy especially in the feet needs careful patient counselling with respect to possible foot ulceration and subsequent implications on an existing prosthesis. I hope this helps, Please let me know if you have any other queries Dr Purushottam Reddy Padala MS(Ortho) FRCS Consultant orthopaedic and joint replacement surgeon. Happy joints orthopaedics Hyderabad.India