Prepatellar Bursitis

Prepatellar bursitis is a painful condition that affects the front of the knee. It causes inflammation and swelling in the prepatellar bursa, a small fluid-filled sac. This sac acts as a cushion between the kneecap and the skin, reducing friction during movement.

When the prepatellar bursa gets irritated or inflamed, it leads to knee pain and discomfort. This makes everyday activities challenging. Understanding the causes of this condition is key for effective management and prevention.

Common symptoms include a visible bump on the front of the knee, tenderness to touch, and increased pain when kneeling. Various treatment options are available to alleviate symptoms and promote healing. These range from conservative measures like rest and ice therapy to more invasive surgical interventions in severe cases.

What is Prepatellar Bursitis?

Prepatellar bursitis is when the prepatellar bursa, a small sac in front of the kneecap, gets inflamed. This bursa helps reduce friction and allows the knee to move smoothly. When it gets irritated, it causes knee pain, swelling, and stiffness.

This condition is also known by other names, depending on the situation. For example:

Many things can cause the prepatellar bursa to get inflamed. This includes direct hits to the knee, repeated kneeling, or infections. The swelling makes the bursa bigger, creating a bump on the knee. This swelling, along with pain and stiffness, can really limit how well you can move.

It’s important to know the signs of prepatellar bursitis. If you have ongoing knee pain, swelling, or stiffness, and it happens after kneeling or getting hit in the knee, see a doctor. They can give you the right treatment.

Anatomy of the Prepatellar Bursa

The prepatellar bursa is a small, fluid-filled sac in front of the kneecap. It cushions and reduces friction, making knee movement smooth and painless.

Location and Function of the Prepatellar Bursa

The prepatellar bursa sits just under the skin and above the kneecap. It acts as a protective cushion. When the knee bends and straightens, it prevents the skin from rubbing against the kneecap’s bone.

This bursa contains lubricating fluid. This fluid helps the knee move smoothly. It also distributes pressure evenly, protecting the kneecap and surrounding tissues.

Surrounding Structures and Their Roles

Several important structures surround the prepatellar bursa. Each plays a key role in knee function and stability:

These structures work together with the prepatellar bursa. They ensure the knee functions properly and protects the joint from damage. Knowing about the prepatellar bursa and its surroundings helps doctors diagnose and treat conditions like prepatellar bursitis.

Causes and Risk Factors of Prepatellar Bursitis

Many things can lead to prepatellar bursitis. These include injuries, overuse, repetitive stress, and occupational hazards. Knowing these risk factors helps people avoid this painful condition.

Acute Injuries and Trauma

Getting hurt, like a blow to the knee or a fall, can irritate the prepatellar bursa. These injuries often happen during sports, accidents, or other activities that involve a lot of impact.

Overuse and Repetitive Stress

Overuse and repetitive stress on the knee can also cause prepatellar bursitis. Activities like gardening, cleaning, or sports that involve kneeling can put too much pressure on the bursa, leading to inflammation.

Jobs and sports that involve a lot of kneeling can increase the risk of getting prepatellar bursitis. These include:

Occupational and Lifestyle Factors

Certain jobs and lifestyle choices can raise the risk of getting prepatellar bursitis. Jobs that require a lot of kneeling, like floor installation, increase the risk. Being overweight or obese also puts extra stress on the knees, making bursitis more likely.

Symptoms of Prepatellar Bursitis

The symptoms of prepatellar bursitis can vary but usually affect the front of the knee. The most common symptom is knee pain, which can be sharp or aching. It often gets worse with movement or when pressure is applied.

Swelling is another common symptom, causing the knee to look bigger. The skin over the kneecap may show redness and warmth, signs of inflammation. The area is usually tender to the touch, and the knee may feel stiff.

This stiffness makes it hard to bend or straighten the leg fully. These symptoms can make everyday activities like walking or climbing stairs tough.

The severity of symptoms depends on the cause and how much the bursa is inflamed. Sometimes, the swelling can be quite noticeable, forming a visible lump or bump on the knee’s front. This swelling can be soft or firm and may change in size over time.

It’s key to remember that knee pain and swelling can also be signs of other knee problems. So, getting a proper diagnosis from a healthcare professional is vital. They can figure out the exact cause of your symptoms and help you find the right treatment.

Diagnosing Prepatellar Bursitis

Getting a correct diagnosis is key to finding the right treatment for prepatellar bursitis. Doctors use a mix of physical exams, imaging tests, and ruling out other conditions to diagnose it.

Physical Examination

Your doctor will check your knee for swelling, redness, and tenderness during a physical exam. They might press gently on the prepatellar bursa to see if it hurts. This helps them check for inflammation or infection.

They will also look at how well your knee moves and its strength. This helps them see if the condition is affecting your mobility.

Imaging Tests: X-rays, MRI, and Ultrasound

Even with a physical exam, your doctor might suggest imaging tests. These tests help rule out other causes of knee pain or check how bad the inflammation is. Common tests include:

• X-rays: X-rays can spot bony problems or calcium deposits that might be causing your pain.
• MRI: MRI scans show detailed images of soft tissues around your knee. They help see how bad the inflammation is and if there are any structural problems.
• Ultrasound: Ultrasound lets your doctor see the prepatellar bursa in real-time. They can check its size, shape, and if there’s fluid or thickening.

Differential Diagnosis: Ruling Out Other Conditions

In some cases, your doctor might need to tell prepatellar bursitis apart from other knee problems. These could include:

Your doctor will look at your symptoms, medical history, and imaging results to accurately diagnose prepatellar bursitis. They will then create a treatment plan to help you feel better and improve your knee function.

Non-Surgical Treatment Options for Prepatellar Bursitis

Most cases of prepatellar bursitis can be treated without surgery. These treatments help reduce inflammation, ease pain, and aid in healing. They aim to fix the root cause and let the knee heal naturally.

Rest, Ice, and Elevation (RICE)

The RICE method is key for treating prepatellar bursitis without surgery. It includes:

Anti-inflammatory Medications and Pain Relief

Over-the-counter anti-inflammatory drugs like ibuprofen or naproxen can help. They reduce inflammation and ease pain. Doctors might also prescribe stronger drugs or inject corticosteroids into the bursa for more relief.

Physical Therapy and Rehabilitation

Physical therapy is vital for treating prepatellar bursitis without surgery. A physical therapist creates a custom plan that includes:

• Exercises to improve flexibility and range of motion in the knee
• Strengthening exercises to support the muscles around the knee joint
• Manual therapy techniques to reduce pain and promote healing
• Education on proper body mechanics and techniques to prevent future flare-ups

By using these non-surgical treatments and working with healthcare professionals, most people can manage prepatellar bursitis. They can go back to their normal activities without needing surgery.

Surgical Interventions for Severe Cases

In severe cases of prepatellar bursitis, surgery might be needed. This is when chronic inflammation doesn’t go away with non-surgical treatments. The main surgery is called bursectomy. It removes the inflamed bursa to ease pain and improve knee movement.

The surgeon makes a small cut over the problem area. Then, they take out the inflamed bursa. Sometimes, they also remove damaged tissue around the bursa to stop future problems. The cut is closed with stitches or staples, and a clean dressing is put on.

Surgery can help severe prepatellar bursitis, but it comes with risks. There’s a chance of infection, bleeding, or nerve damage. After surgery, you might need to move less and do physical therapy to get your knee strong again.

If you’re thinking about surgery, talk to your doctor about the good and bad sides. Often, surgery and physical therapy after can fix chronic inflammation and make your knee work right again.

Prevention Strategies for Prepatellar Bursitis

To prevent prepatellar bursitis, it’s important to take steps to lower the risk. By using effective prevention strategies, you can protect your knee and avoid the pain of this condition.

Protective Gear and Padding

Using protective gear and padding is a key strategy. When kneeling often or at risk of knee impact, knee pads or cushioned supports can help. They absorb shock and reduce pressure on the prepatellar bursa. This is vital for those in jobs that involve a lot of kneeling, like flooring installers or gardeners.

Proper Technique and Biomechanics

Keeping proper technique and biomechanics is also critical. When kneeling, spread your weight evenly and avoid putting too much pressure on one knee. In sports or exercises with repetitive knee movements, use the right form to lessen knee stress. Getting advice from a coach or trainer can help you use the right biomechanics.

Maintaining Flexibility and Strength

Regular stretching and strengthening exercises are key to preventing prepatellar bursitis. Keeping your quadriceps, hamstrings, and calf muscles flexible reduces knee joint tension and improves movement. Strength training exercises like leg extensions and hamstring curls can also help stabilize the knee and lower injury risk. A balanced exercise routine that includes flexibility and strength exercises is good for your knee’s health and resilience.