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Is An Itchy Rash On The Knee After Knee Replacement A Serious Concern?
Question: I had total knee replacement May 18, 2018. Four weeks later I developed a rash around the knee which has now spread to my face. The rash on the affected leg has subsided, but my waist, and now face are driving me crazy. Saw an urgent care dr that put me on steroid ( 6 day) and steroid cream. Family dr. order another cream but both dr.s mentioned, am I allergic to something within the new knee. the rash is spreading like crazy and the itch is terrible. Surgeon on vacation, saw it but didn't think anything with surgery is the cause. any ideas?
Brief Answer:
Allergy to the metal of the knee prosthesis can be a possible cause
Detailed Answer:
Hello,
It is rare but well recognized that knee prosthesis can in some patients cause the allergic reaction due to the metal/alloy used. Both Nickel and Cobalt used as metals in knee prosthesis may cause the reaction to some patients. The rash, in this case, is very pruritic (very itchy). Especially the patients who tend to have an allergy (contact dermatitis) to some jewelry (containing nickel) are more likely to develop this allergy to the knee prosthesis.
Generally the way these patients are treated is with oral steroids for some days and steroid cream on the areas of the rash. It is important that you use the treatment as given. Some patients will improve and the rash will subside and some will continue to have the itchy rash with some needing a second surgery.
Unfortunately, there is no way to know how a patient will react but taking the treatment and observation with time is necessary. Any worsening of symptoms or if you are not better in 2 weeks from starting oral steroids you will need to talk again with your doctor. The visit will help re-evaluate you and also rule out other causes for the rash.
Meanwhile, if the itchiness is bad and does not allow you to sleep at night, you can take chlorpheniramine 4 mg tablet before bed to reduce itchiness and help you sleep better and rest.
Please be cautious if you are using oral steroids for longer than 7 days, you will need to be very careful and not to stop it suddenly as it might cause serious symptoms that can be dangerous. Steroids need to wean off gradually and you need to be under strict supervision of your doctor during the course.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Antoneta Zotaj, MD
Allergy to the metal of the knee prosthesis can be a possible cause
Detailed Answer:
Hello,
It is rare but well recognized that knee prosthesis can in some patients cause the allergic reaction due to the metal/alloy used. Both Nickel and Cobalt used as metals in knee prosthesis may cause the reaction to some patients. The rash, in this case, is very pruritic (very itchy). Especially the patients who tend to have an allergy (contact dermatitis) to some jewelry (containing nickel) are more likely to develop this allergy to the knee prosthesis.
Generally the way these patients are treated is with oral steroids for some days and steroid cream on the areas of the rash. It is important that you use the treatment as given. Some patients will improve and the rash will subside and some will continue to have the itchy rash with some needing a second surgery.
Unfortunately, there is no way to know how a patient will react but taking the treatment and observation with time is necessary. Any worsening of symptoms or if you are not better in 2 weeks from starting oral steroids you will need to talk again with your doctor. The visit will help re-evaluate you and also rule out other causes for the rash.
Meanwhile, if the itchiness is bad and does not allow you to sleep at night, you can take chlorpheniramine 4 mg tablet before bed to reduce itchiness and help you sleep better and rest.
Please be cautious if you are using oral steroids for longer than 7 days, you will need to be very careful and not to stop it suddenly as it might cause serious symptoms that can be dangerous. Steroids need to wean off gradually and you need to be under strict supervision of your doctor during the course.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Antoneta Zotaj, MD
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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