Brief Answer:
Bone tumour, Osteochondritis dessicans, Infection

Detailed Answer:
Hi there.

Thanks for the query.

Do you have any pain around the knee or both knees ?

Do you have knee pain at night which wakes you up or does not let you sleep peacefully ?

Have you lost weight or appetite recently ?

Has your Doctor mentioned what he suspects you have after a thorough examination ?

An unidentifiable lesion near the knee cap could be due to many possible reasons. Commonly bone tumours can occur near the knee joint, certain cartilage - bone injury can occur especially in a setting of trauma. Osteochondritis dessicans usually occurs in both knees and is due to chronic cartilage damage in the knee cap region. Also bony infections can present near the knee.

Your Orthopaedic surgeon would examine you thoroughly and advise necessary investigations like Xray, CT Scan or MRI Scan or even a Bone scan. A bone scan can help to delineate the above mentioned bony lesions and help plan the management.

If you have pain, you can apply ice to the area and take pain killers. Keep the limb elevated of there is swelling.

If you have any reports, kindly upload them for my review so that I can be in a better position to help you understand the condition and help find the right approach for you.
I hope I have answered your query.

I will be available to answer your follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

---

Brief Answer:
Infection, loose knee implants

Detailed Answer:
Hi there.

Have you had a PKR before ?

Has your toe osteomyelitis been treated successfully ?

There may be suspicion of infection after the PKR surgery for which your Doctor wants to do a bone scan to look for hot spot in the scan. This could nearly confirm the presence of infective focus. Also knee aspiration and culture of the joint fluid will be specific for diagnosis of the infective organism causing the infection. Also CRP laboratory blood investigation will help to detect the presence of infection.

If there is infection detected, revision surgery could be indicated if the knee components have gotten loose.

Regards,

Dr. Aashish Raghu

---

Brief Answer:
Revision surgery PKR is there is implant loosening due to infection

Detailed Answer:
Hi there.

Your Doctor is going in the right direction to look for any infection or other pathology close to the PKR site. Once that is diagnosed and treated, revision of the PKR may be required especially if the implants have loosened. This revision shall hopefully stabilise your joint.

Kindly follow up with me in this regard.

Regards,

Dr. Aashish Raghu

---

Brief Answer:
Kindly follow up

Detailed Answer:
Hi there.

As I have mentioned earlier certain laboratory investigations may be needed as well like ESR CRP and Joint fluid culture. This will help to pin point the presence of infection.

Kindly follow up with me on your status.

Regards,

Dr. Aashish Raghu

---

Brief Answer:
Hope you find relief after the revision surgery

Detailed Answer:
Hi there.

If you feel grinding and rubbing sensation in the operated knee then the implants could have loosened or malaligned. Also possible is arthritis of the other compartment which hasn't been operated on yet and presence of infection.

The fluid in your knees need to be aspirated and tested for infection. Also if you are getting the feeling of instability while walking or flexing the knee then it needs to be revised due to loosening and malalignment.

Once the type of complication has been ascertained and treated along with revision surgery, you should feel much better.

The nerve block will numb the painful area till the surgery.

You are going through a lot right now and I hope you find good relief after the surgery and not have any further complications.

Wishing you a speedy recovery.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

---

Brief Answer:
Infection and loosening can show up similarly on a bone scan in sometimes

Detailed Answer:
Hi there.

Yes, loosening of PKR metallic components usually do show up on a bone scan but a PET CT would be more specific. Also infection can show hot spots on a bone scan. Since there could be common signs on a Bone scan for the above mentioned problems, a knee joint fluid aspirate will help to clinch the presence or absence of infection as a cause of the loosening and the appropriate antibiotic to treat it will be found and administered to eradicate the offending infection if any.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

---