Prepatellar Bursitis: Causes, Symptoms, and Treatment

What is Prepatellar Bursitis?

A bursa is a small, fluid-filled sac that reduces friction between tissues, such as bone and soft tissue. The prepatellar bursa is situated between the skin and the kneecap. When this bursa becomes irritated or inflamed, it can lead to pain, swelling, and reduced mobility in the affected knee.

Causes of Prepatellar Bursitis

Repetitive Trauma

• Frequent kneeling on hard surfaces (e.g., cleaners, carpenters, or gardeners).

• Sports-related pressure (e.g., wrestling or football).

Acute Injury

• A direct blow to the kneecap can irritate or damage the bursa.

Infection (Septic Bursitis)

• Bacterial infections may occur if the skin over the bursa is broken, leading to an inflamed, swollen bursa.

Other Causes

• Medical Conditions: Conditions like gout or rheumatoid arthritis can predispose individuals to bursitis.

Symptoms of Prepatellar Bursitis

• Swelling: Noticeable swelling over the kneecap, often resembling a fluid-filled sac.

• Pain: Tenderness or discomfort, especially when kneeling or applying pressure.

• Redness and Warmth: Common in cases of infection (septic bursitis).

• Restricted Mobility: Difficulty bending the knee due to swelling or pain.

Diagnosing Prepatellar Bursitis

Clinical Assessment

• History and Physical Examination: A physiotherapist or physician will assess swelling, redness, and tenderness around the knee.

Imaging Studies

• Ultrasound: Detects fluid accumulation in the bursa.

• X-Ray: Rules out fractures or bone abnormalities.

• MRI: Used in chronic or complex cases to assess deeper structures.

Laboratory Tests

• If infection is suspected, fluid from the bursa may be aspirated and analyzed.

Treatment for Prepatellar Bursitis

Non-Surgical Treatment

1. Initial Management (RICE Protocol)

   • Rest: Avoid activities that exacerbate the symptoms.

   • Ice: Apply ice packs to reduce swelling and inflammation.

   • Compression: Use a knee wrap to minimize swelling.

   • Elevation: Elevate the leg to reduce fluid buildup.

2. Medications

   • Non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation.

   • Antibiotics for septic bursitis caused by infection.

3. Physical Therapy

   • Stretching and Strengthening: Improve knee function and support surrounding muscles.

   • Activity Modifications: Reduce repetitive kneeling or pressure on the knee.

4. Aspiration

   • A healthcare professional may drain excess fluid from the bursa to alleviate swelling and discomfort.

5. Corticosteroid Injections

   • Used in persistent or severe cases to reduce inflammation.

Surgical Treatment

• Rarely required, but surgical removal of the bursa (bursectomy) may be necessary in recurrent or non-responsive cases.

Recovery and Prognosis

• Most cases of prepatellar bursitis improve with conservative management within a few weeks.

• Chronic or recurrent cases may take longer to resolve.

• Septic bursitis requires prompt treatment to prevent complications.

Preventing Prepatellar Bursitis

• Protective Gear: Use knee pads or cushioning when kneeling on hard surfaces.

• Activity Modifications: Avoid prolonged kneeling or repetitive pressure on the knee.

• Good Hygiene: Keep the skin over the knee clean and free of cuts to prevent infection.

• Strength Training: Strengthen muscles around the knee to reduce strain.

If you are experiencing knee pain or suspect prepatellar bursitis, our team at Palms Physiotherapy & Allied Health can develop a tailored treatment plan to support your recovery.