Knee bursitis

Knee bursitis is a common condition that can cause significant discomfort and limit mobility. It occurs when the small, fluid-filled sacs called bursae, which act as cushions between bones, tendons, and muscles, become inflamed. This inflammation can be caused by repetitive motion, injury, or infection. In this blog post, we will explore the causes, symptoms, and treatment options for knee bursitis, with a focus on prepatellar bursitis, a specific type of knee bursitis affecting the front of the kneecap.

What is Prepatellar Bursitis?

Prepatellar bursitis, also known as 'housemaid's knee' or 'carpenter's knee', is a condition that occurs when the bursa located in front of the kneecap (patella) becomes inflamed. This bursa acts as a cushion between the kneecap and the skin, reducing friction and preventing irritation. When the prepatellar bursa becomes inflamed, it can cause swelling, pain, and tenderness in the front of the knee.

Prepatellar bursitis is often caused by repetitive kneeling, which puts pressure on the bursa and can lead to inflammation over time. This is why the condition is commonly seen in individuals who frequently kneel for work or leisure activities, such as cleaners, carpenters, and gardeners. Other causes of prepatellar bursitis include acute trauma to the knee, infection, and certain medical conditions like rheumatoid arthritis or gout. Symptoms of prepatellar bursitis may include swelling, pain, warmth, and redness in the affected area, as well as limited range of motion in the knee. If left untreated, the condition can become chronic and lead to further complications. Fortunately, there are several effective knee bursitis treatment options available, which we will discuss in the following sections.

Knee bursitis is a condition characterised by the inflammation of the bursae around the knee joint. This inflammation can lead to a range of symptoms that may vary depending on the specific bursa affected and the underlying cause of the inflammation.

• Pain: One of the most common symptoms of knee bursitis is pain, especially when moving the knee or applying pressure to it. The pain may be localised to the affected area or radiate to the surrounding tissues.

• Swelling: Visible swelling and redness around the affected bursa is another common symptom. The swelling may be more pronounced in certain types of bursitis, such as prepatellar bursitis, where the swelling occurs over the kneecap.

• Warmth: The affected area may feel warm to the touch, indicating the presence of inflammation.

• Tenderness: The affected area may be sensitive to touch or pressure, causing discomfort or pain.

• Limited mobility: In some cases, the pain and swelling associated with knee bursitis can lead to difficulty in moving the knee, limiting the range of motion and affecting daily activities.

In addition to these general symptoms, specific types of knee bursitis may present with unique signs. For example, pes anserine bursitis, which affects the bursa on the inner side of the knee, is particularly common in obese women with osteoarthritis. Infectious bursitis may also present with additional symptoms such as fever, chills, and skin changes indicative of an infection.

Prepatellar bursitis is a specific type of knee bursitis that affects the bursa located in front of the kneecap (patella). This condition can be caused by various factors, leading to inflammation, pain, and swelling in the affected area.

• Repeated pressure: One of the most common causes of prepatellar bursitis is frequent and prolonged kneeling, particularly on hard surfaces. This repeated pressure can irritate the bursa and lead to inflammation.

• Direct trauma: A direct blow to the knee, such as from a fall or impact during sports, can cause damage to the prepatellar bursa and trigger inflammation.

• Infection: In some cases, prepatellar bursitis can be caused by a bacterial infection that enters the bursa through a cut or bruise near the knee. This type of infectious bursitis requires prompt medical attention and antibiotic treatment.

Prepatellar bursitis can affect individuals from various demographics and professions. While it predominantly affects middle-aged men between the ages of 40 and 60, prepatellar bursitis can occur in any age group, including children.

• Occupational risks: Individuals with jobs that involve frequent kneeling, such as plumbers, roofers, carpet layers, coal miners, gardeners, carpenters, and housemaids, are at higher risk of developing prepatellar bursitis.

• Athletes and sports: Athletes participating in sports that involve direct blows or falls on the knee, like football, wrestling, or basketball, are also at increased risk of knee bursitis.

• Underlying health conditions: People with chronic inflammatory diseases, such as rheumatoid arthritis or gout, and those with immunosuppressive conditions, like diabetes mellitus or chronic steroid use, are more susceptible to developing prepatellar bursitis.

Preventing knee bursitis involves taking steps to reduce pressure and friction on the knee joint.

• Using protective gear like kneepads can help if you work on your knees or participate in contact sports. Taking regular breaks to rest and stretch your knees is especially important if your job involves kneeling for long periods.

• Maintaining a healthy weight is another key factor in preventing prepatellar bursitis and other types of knee bursitis. Excess weight puts additional stress on the knee joints, increasing the risk of developing bursitis. Engaging in regular exercise and maintaining a balanced diet can help you achieve and maintain a healthy weight.

• Proper footwear is also essential in preventing knee bursitis. Choose shoes with good arch support and cushioning to absorb shock and reduce stress on the knees. Avoid high heels and shoes with minimal support, as they can put extra strain on the knee joints.

• Gradually increasing the intensity and duration of physical activities can help prevent overuse injuries that lead to knee bursitis. Avoid sudden increases in activity levels and allow your body time to adjust to new exercises or sports.

Diagnosing prepatellar bursitis involves a combination of medical history, physical examination, and sometimes additional tests to determine the underlying cause and severity of the condition.

• Symptom assessment: During the consultation, the doctor will discuss the patient's symptoms, including the severity of pain, duration of symptoms, and any activities that exacerbate the knee bursitis.

• Physical examination: The doctor will inspect the affected knee, comparing it to the healthy knee, and check for tenderness, swelling, warmth, and range of motion. They will also assess for signs of infection, such as fever or chills.

• Imaging tests: In some cases, imaging tests like X-rays or MRI scans may be ordered to rule out other conditions or to assess the extent of damage to the knee bursa.

• Aspiration: If the bursitis is suspected to be caused by an infection, the doctor may perform an aspiration, which involves using a needle to remove fluid from the affected bursa for laboratory analysis.

Knee bursitis can be managed and treated through various methods, depending on the severity and cause of the condition. Non-surgical treatments for knee bursitis include:

• Rest: Avoid activities that worsen symptoms and opt for low-impact exercises like cycling or using an elliptical machine.

• Ice: Apply ice 3-4 times a day for 20 minutes to reduce swelling and pain.

• Elevation: Elevate the affected leg to reduce swelling.

• Medication: Use nonsteroidal anti-inflammatory medicines such as ibuprofen or naproxen to relieve pain and control inflammation. Acetaminophen can be used as an alternative.

• Compression: Use compression sleeves or wraps to reduce swelling.

• Aspiration and corticosteroid injections may also be used in knee bursa treatment. Aspiration involves draining the bursa with a needle to reduce excess fluid and test for infection, while corticosteroid injections can reduce inflammation and relieve pain.

• Physical therapy, including strengthening and flexibility exercises, can improve strength, flexibility, and reduce the risk of recurring bursitis.

If knee bursitis is caused by a bacterial infection, antibiotics will be prescribed. In some cases, surgical drainage may be required if the infection does not respond to antibiotics alone. Arthroscopic bursectomy, a minimally invasive surgical procedure to remove the bursa, is typically considered a last resort when conservative treatments fail to provide knee bursitis relief.

If you experience persistent knee pain, swelling, or stiffness that does not improve with home remedies, it is important to consult a doctor. Seek medical attention if you notice any of the following knee bursitis symptoms:

• Severe pain that limits your ability to move your knee

• Significant swelling or redness around the knee

• Fever, chills, or other signs of infection

• Inability to bear weight on the affected leg

• Visible lumps or deformities around the knee

Your doctor will perform a physical examination and may order imaging tests like X-rays or MRIs to diagnose knee bursitis accurately. They will also help determine the underlying cause of your condition and recommend the most appropriate knee bursitis therapy based on the severity of your symptoms.

Early diagnosis and treatment can help prevent complications and promote faster recovery from knee bursitis. By working closely with your doctor and following their recommended treatment plan, you can effectively manage your symptoms and reduce the risk of recurrent episodes.