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Should I be concerned about redness and flaking in my knee?

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Answered by

Orthopaedic Surgeon
Practicing since : 2005
Answered : 43 Questions
My right knee has had two surgeries. One to take out bone fragments and tendon from a broken patella in 2003 which happened during an explosion in Kuwait that threw me into the ground. I could not run after that but had a great deal of freedom until 2007 when I started having stability problems. After many tests a sports surgeon advised a lateral release. It made things worse and I now wear a brace and use a cane or crutches. My swelling never disappeared and the only thing that seemed to get it stronger was physical therapy in and out of pool. Recently the knee turns red, pain increases and the skin on it is flaking. I am a Vet and rely on the VA, but they will not send me for another ortho exam and stopped my physical therapy after two months claiming a lack of funding. My concern is this redness and flaking that I have never had before. The only thing on my knee is a cotton thin sock like tube which is under my brace. The brace does not touch the knee in this area as it supports the sides so my knee joint is not tilted. Is this new development something I should be concerned with?
Posted Tue, 24 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Sangeet 14 hours later
Hello Sir,

Your history says you had a fracture of the patella with tendon injury 8 years back and was re-operated in 2007.

To understand your problem better and help you out, kindly reply to my questions.
- Does this redness progress on walking and is it associated with swelling and pain?
- does it aggravate on climbing stairs?
- Do you have any fever?
- Do your knees get locked all of a sudden while walking?

With a peek into your problems, I think it could be any of the below:
- Patellofemoral arthritis.
- A loose body within the knee.
- Infection within the joint.

However clinical co-relation is advisable before jumping to the diagnosis.
For the time being, if your knee is swollen and painful, apply ice and avoid walking.

Please answer to the above questions as this will help me in suggesting you better.

Awaiting your reply.
Above answer was peer-reviewed by
Follow-up: Should I be concerned about redness and flaking in my knee? 4 hours later
- Does this redness progress on walking and is it associated with swelling and pain?
It seems to remain constant for a few days and then it disappears and returns. The pain seems to have increased with sensitivity at the bottom and on the sides of the patella when this happens.

- does it aggravate on climbing stairs?
Stairs have always aggravated my knee and I just usually bare it.

- Do you have any fever?
No fever.

- Do your knees get locked all of a sudden while walking?
That is the one symptom I am grateful I never had. I have had stability problems and before the current brace was getting “knock-kneed?”.

Answered by Dr. Sangeet 1 hour later

Thanks for writing back in faith.

Based on the questions you answered, in my view it's a patellofemoral arthritis, perhaps in the early phase. It usually presents with the mentioned symptoms and starts earlier if there was any trauma.

An X-ray of your knee joint (if not done 3-4 months back) would show evidence of arthritis.

As I have no visual approach to your scenario, I suggest you based on the following possibilities.
- For early arthritis, active quadriceps exercises, as taught by a Physiotherapist will delay end stage arthritis by a few years.
- For late stages, patellofemoral joint replacement would be advisable. It would however be expensive. A joint replacement would alleviate most of your symptoms.
- For intermittent swelling and pain, use a joint compression bandage, ice and analgesic sprays and give adequate rest till the swelling subsides.

I would also suggest you to visit an arthroscopy surgeon. The exact cause of your pain and the joint condition can be assessed by a diagnostic arthroscopy.

I hope i have answered all your queries. For further queries, please write back to me. I will be available for follow up.

Thank you.
Above answer was peer-reviewed by
Follow-up: Should I be concerned about redness and flaking in my knee? 2 hours later
Would pool and other types of physical therapy be of any benefit or am I looking at knee replacement in he long run. I am 60 now.
Answered by Dr. Sangeet 49 minutes later
Hello again,

Knee replacement is the final and best option for the long run.

Pool therapy is definitely helpful. However active quads as advocated by your physio would relieve your pain much more as compared to the former. It will improve your knee stability as well as relieve the pain. Avoid all exercises when the knee is swollen.

These exercises will postpone your need for surgery by relieving the pain and wear and tear. Weight reduction will also only better the prognosis.

Hope I have answered your queries. I will be available for further follow up.

Thank you. Wish you good health.
Above answer was peer-reviewed by
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