However, media and fans shouldn't panic as Rose will shake off that rust come playoff time.
Rose, who missed 12 games with a groin injury, played for the first time since March 12 when D-Rose injured himself when Knicks point guard Jeremy Lin blocked him.
D-Rose's production struggled mightily early on. Knicks guards Iman Shumpert and Landry Fields frustrated Rose as he drove to the hoop throughout the first half.
New York was able to limit Rose to 1-of-6 shooting and five turnovers in the first half as the Simeon product had shaky passing, like missing an open Kyle Korver on a fast break.
When the second half rolled around, Rose looked more like his old self. The Bulls star cranked out seven field goals and 21 points the remainder of the contest.
Rose then converted an amazing four-point play while Shumpert fouled him to give the Bulls a 89-80 lead late.
His passing also was a bit better in the second half and overtime periods for four assists, but he still was missing that pinpoint accuracy needed to secure Chicago easy buckets.
Rust then reared its ugly head once more as Rose bricked two late fourth-quarter free throws and missed a potential game-winning jumper in regulation by pulling up too soon instead of driving.
In the overtime period and with the Bulls winning 95-93, Rose knifed through the lane past Tyson Chandler for a nice layup to increase the Bulls' lead. However, Rose later missed another potential game-winner on a runner along the left wing Chandler contested.
Should we worry about Derrick Rose's effectiveness?
Rose finished the game with 29 points on 8-of-26 shooting, six rebounds, four assists and eight turnovers. Rose's jumper was a bit flat because he lacked lift, but that will be quickly correctable through repetition.
Bulls fans and media might jump to the conclusion that Rose had a horrible game, but they need to remember Rose didn't play NBA ball for a month. Also, the Knicks did a great job clogging up the lane and making life miserable on a rusty Rose.
Rose's turnovers could be attributed to being out of the offensive system. The Bulls' starters are used to having C.J. Watson and John Lucas III calling the shots while Carlos Boozer is the first option.
Richard Hamilton and Rose are now back into the rotation and are attempting to regain offensive timing with teammates. While Rose's return was a bit rough, he has nine games to get back into playing shape.
And Rose missing those clutch plays shouldn't be a cause of concern. While Rose bricked free throws against the Miami Heat that cost the game as well, he has won countless games as well. Ones that come to mind are the Christmas win over the Los Angeles Lakers and the March 8th buzzer-beater against the Milwaukee Bucks.
Rose is a clutch player, and clutch players come through more often than not.
Not playing for a month takes its toll on any athlete, and rust needs time and repetition to shake off.
Tuesday offers Rose and the Bulls an opportunity for revenge as the Knicks travel to the United Center. In his second game back, expect D-Rose's game to be a bit more smooth and flashy.
Same goes for the next eight games as Rose tunes up for the playoffs.