Prepatellar (Knee) Bursitis

What is prepatellar bursitis?

Prepatellar bursitis is an irritation or inflammation of a bursa in your knee. A bursa is a fluid-filled sac that surrounds joints or tendons. A bursa reduces friction by cushioning muscles or tendons and bones that move back and forth across each other.

There are several bursae in the knee. The prepatellar bursa is located just in front of the kneecap near the attachment of the kneecap (patellar) tendon. Prepatellar bursitis is also called housemaid's knee from when maids were injured cleaning floors on their knees. The injury is common in wrestlers, who get it from their knees rubbing on the mats. Volleyball players get it from diving onto their knees for the ball.

How does it occur?

Bursitis can result from:

• overuse
• a direct blow to the area
• chronic friction, such as from frequent kneeling

What are the symptoms?

Prepatellar bursitis causes pain and swelling over the front of the knee. You may have pain when you bend or straighten your leg.

How is it diagnosed?

Your healthcare provider will examine your knee for tenderness over the bursa. He or she may use a needle and syringe to get a sample of fluid from the bursa to check for infection and look for other causes of the bursitis. You may have X-rays and blood tests.

How is it treated?

Treatment may include:

• Rest the joint that is hurting.
• Do not put any pressure on the sore and swollen area until the swelling subsides.
• Using ice packs on your knee for 20 to 30 minutes every 3 to 4 hours for 2 or 3 days or until the pain goes away.
• Using a knee sleeve or wrapping an elastic bandage around your knee to reduce any swelling or to prevent swelling from occurring.
• Taking anti-inflammatory medicine. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider's approval.
• Removal by your healthcare provider of some of the fluid within the bursa if it is very swollen.
• Injection of a corticosteroid medicine into the swollen bursa.
• Leg stretching exercises.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and if you have had a previous injury. Recovery time also depends on the severity of the injury. The pain from prepatellar bursitis is usually gone within a few weeks although there may be painless swelling for up to several months.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your activities when, starting from the top of the list and progressing to the end, each of the following is true:

• Your injured knee can be fully straightened and bent without pain.
• Your knee and leg have regained normal strength compared to the uninjured knee and leg.
• Your knee bursa is not swollen or tender to touch.
• You are able to put pressure on your bursa (such as kneeling) without pain or swelling.
• You are able to walk or jog straight ahead without limping.

How can I prevent prepatellar bursitis?

Prepatellar bursitis is best prevented by avoiding direct blows to the kneecap area and by avoiding prolonged kneeling. Proper protective kneepads will help prevent inflammation of the bursa.