Knee Bursitis: How To Recognise, Treat, And Prevent It

What Is Knee Bursitis (Prepatellar Bursitis)?

Prepatellar bursitis, commonly known as housemaid's knee, is a condition characterised by inflammation of the small, fluid-filled sac (bursa) located in front of the kneecap (patella). The prepatellar bursa acts as a cushion between the kneecap and the skin, reducing friction during movement. When this bursa becomes irritated or inflamed due to repetitive pressure, injury, or infection, it results in knee bursitis. The swollen bursa causes pain, tenderness, and limited range of motion in the affected knee, making everyday tasks like walking, kneeling, or climbing stairs challenging.

Types of Prepatellar Bursitis

There are two main types of prepatellar bursitis:

• Aseptic (non-infectious) bursitis: Caused by repeated pressure or trauma to the knee.
• Septic (infectious) bursitis: Caused by bacterial infection of the bursa, often through a break in the skin.

Symptoms of Knee Bursitis

The symptoms of knee bursitis can vary depending on the underlying cause and severity of the condition. Common bursitis knee symptoms include:

• Swelling: A noticeable bump or swelling may appear over the kneecap, which can develop gradually or suddenly.
• Pain and tenderness: You may experience an aching pain or tenderness in the front of the knee, especially when pressure is applied or during movement.
• Redness and warmth: The skin over the affected area may appear red and feel warm to the touch.
• Stiffness and limited mobility: Knee bursitis can make it difficult to bend or straighten your knee fully.

In cases of septic bursitis, you may also experience:

• Fever and chills
• Intense redness and swelling
• Pus drainage if the infection breaks through the skin

Chronic prepatellar bursitis may cause ongoing swelling and thickening of the bursa, leading to visible puffiness over the kneecap

If you notice any of these bursitis symptoms, it's essential to consult a doctor for an accurate diagnosis and an appropriate treatment plan.

Bursitis of the Knee Causes

Knee bursitis can develop due to various factors, including:

• Repetitive kneeling: Occupations or activities that involve frequent kneeling, such as carpentry, plumbing, or gardening, can put excessive pressure on the prepatellar bursa.
• Direct trauma: A fall, blow, or other injury to the front of the knee can cause the bursa to become inflamed.
• Infection: Bacteria can enter the bursa through a cut, scrape, or insect bite, leading to septic bursitis.
• Overuse: Engaging in strenuous activities or sports that put repeated stress on the knees can irritate the bursa.
• Certain medical conditions: Underlying health issues like rheumatoid arthritis, gout, or osteoarthritis can increase the risk of developing prepatellar bursitis.

Risk Factors

Certain factors can make you more susceptible to developing prepatellar bursitis, such as:

• Occupations requiring frequent kneeling, like carpet laying or floor installation
• Participating in contact sports or activities with repetitive knee stress
• Being middle-aged or older
• Having a history of knee injuries or surgeries
• Living with arthritis, particularly rheumatoid or osteoarthritis
• Being overweight or obese may increase stress on the knee joint, which can worsen irritation of the bursa over time.

Diagnosis & Tests

If you suspect you have prepatellar bursitis, your doctor will typically start with a thorough medical history and physical examination. They may ask about your symptoms, occupation, recent injuries, or any signs of infection. During the physical exam, your doctor will:

• Check for localised swelling, tenderness, warmth, and redness.
• Assess your knee's range of motion.
• Compare both knees to identify any differences.
• Look for signs of infection, such as fever or skin changes.

Imaging Tests

In some cases, your doctor may recommend imaging tests to rule out other potential causes of knee pain or to assess the extent of the inflammation:

• X-rays: While X-rays don't visualise the bursa itself, they can help identify any bone abnormalities, fractures, or signs of arthritis.
• MRI: Magnetic resonance imaging provides detailed images of soft tissues, including the bursa, which can help evaluate the severity of the inflammation and guide bursitis treatment
• Ultrasound: This imaging technique can detect excess fluid within the bursa and may be used to guide aspiration procedures.

Aspiration

If your doctor suspects an infection or gout as the underlying cause of your prepatellar bursitis, they may perform a procedure called aspiration. This involves using a needle to draw fluid from the affected bursa, which is then analysed in a laboratory for the presence of bacteria, crystals, or blood. Aspiration not only helps diagnose the specific cause of prepatellar bursitis but can also relieve pressure and discomfort by draining excess fluid.

Treatment

The treatment approach for prepatellar bursitis depends on the underlying cause, severity of symptoms, and individual factors. In most cases, conservative measures are sufficient to manage the condition effectively.

Medications

Here are a few medications that may be used for treating prepatellar bursitis:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter or prescription NSAIDs like ibuprofen or naproxen can help reduce pain and inflammation associated with prepatellar bursitis.
• Antibiotics: If the bursitis is caused by a bacterial infection, your doctor will prescribe a course of oral antibiotics to clear the infection and prevent complications.
• Corticosteroid injections: In cases of severe inflammation or persistent symptoms, your doctor may recommend a corticosteroid injection directly into the affected bursa to provide rapid relief.
• Pain relievers: Acetaminophen or other pain medications may be recommended to manage discomfort as needed.

Physical Therapy

Physical therapy can play a crucial role in the recovery process for individuals with prepatellar bursitis. A skilled physical therapist can:

• Guide you through exercises to improve knee strength and flexibility.
• Use techniques like ice therapy or ultrasound to reduce swelling and pain.
• Teach you proper body mechanics and techniques to minimize stress on your knees during daily activities.
• Recommend appropriate knee supports or braces to protect the affected area during healing.

Regular physical therapy sessions, combined with a home exercise programme, can help you regain knee function and prevent future flare-ups.

Surgery and Other Procedures

In rare cases, more invasive treatments may be necessary to manage prepatellar bursitis:

• Aspiration: As mentioned earlier, draining the bursa can provide relief and aid in diagnosis.
• Surgical removal: If the prepatellar bursitis is chronic, recurrent, or unresponsive to conservative treatments, your doctor may recommend surgical removal of the affected bursa.
• Debridement: For persistent infections, a procedure to remove infected or thickened bursal tissue may be performed.

It's essential to discuss the potential risks and benefits of any surgical intervention with your doctor to determine the most appropriate course of action for your individual case.

Lifestyle and Home Remedies

In addition to bursitis treatment, there are several self-care measures you can take to manage knee bursitissymptoms and promote healing:

• Avoid activities that put direct pressure on your knees or cause pain. Give your affected knee ample time to recover.
• Apply cold packs to your knee for 15-20 minutes at a time, several times a day, to reduce swelling and numb pain.
• Use an elastic bandage or compression wrap to support your knee and minimise swelling.
• When resting, keep your affected leg elevated above the level of your heart to help reduce swelling.
• Use knee pads or cushioning to protect your knees during activities that require kneeling.
• Avoid prolonged kneeling or putting direct pressure on your knees whenever possible.
• Be vigilant for signs of infection, such as increasing redness, warmth, or fever. If you suspect an infection, seek prompt medical attention.

By incorporating these lifestyle modifications and home remedies, you can actively participate in your recovery process and help prevent future episodes of prepatellar bursitis.

Conclusion

Prepatellar bursitis, or "housemaid's knee", is a common condition that can significantly impact your daily life. By understanding the causes, symptoms, and treatment options for this condition, you can manage your symptoms effectively and prevent future flare-ups. Rest, ice, anti-inflammatory medications, and physical therapy are often successful treatments. If you experience persistent or severe bursitis knee symptoms, don't hesitate to consult a doctor for personalised guidance and treatment.

At Metropolis Healthcare, we understand the importance of accurate diagnosis and personalised care in managing conditions like prepatellar bursitis. Our team of skilled phlebotomists provides convenient at-home sample collection, ensuring a comfortable and hassle-free experience. With our state-of-the-art diagnostic facilities and commitment to delivering reliable results, you can trust Metropolis Healthcare to support you on your journey to better knee health.

FAQs

1. How do you cure bursitis in the knee?

Most cases of knee bursitis can be effectively managed through a combination of rest, ice application, compression, anti-inflammatory medications, and avoiding activities that aggravate symptoms. If the bursitis is caused by an infection, antibiotics will be necessary to cure the underlying infection.

2. What happens if knee bursitis is left untreated?

If knee bursitis is left untreated, it can lead to chronic pain, reduced mobility, and difficulty performing daily activities. In cases of septic bursitis, untreated infection can spread to other parts of the body, causing serious complications.

3. Is it okay to walk with knee bursitis?

Gentle walking is usually safe and recommended to maintain knee mobility, as long as it doesn't cause significant pain or discomfort. However, it's essential to listen to your body and avoid activities that exacerbate your symptoms. If walking becomes difficult or painful, consult your doctor for guidance.

4. What is the fastest way to cure bursitis?

The fastest way to alleviate bursitis symptoms is to rest the affected joint, apply ice, and take over-the-counter anti-inflammatory medications as directed. However, the actual healing time depends on the severity of the inflammation and the underlying cause. For best results, consult a medical professional for personalised treatment recommendations.

5. Can bursitis repair itself?

In some cases, mild knee bursitis may resolve on its own with proper rest and self-care measures. However, if symptoms persist, worsen, or are accompanied by signs of infection, it's crucial to seek medical attention for an accurate diagnosis and appropriate treatment plan.