Your doctor will: Compare the condition of both knees, particularly if only one is painful Gently press on areas of your knee to detect warmth, swelling and the source of pain Inspect the skin over the tender area for redness or other signs of infection Carefully move your legs and knees to determine your knee's range of motion and whether it hurts to bend or flex it.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Canoso JJ. Knee bursitis. Accessed Dec. Arthritis Foundation. Bursitis and tendinitis. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program. If your doctor is uncertain whether or not the bursa is infected, a needle may be inserted into the bursa and the fluid removed. This fluid will be sent to a lab for tests to determine whether infection is present, and if so, what type of bacteria is causing the infection and what antibiotic will work best to cure the infection.
If an infection is found to be causing the prepatellar bursitis, the bursa will need to be drained with a needle, perhaps several times over the first few days. You will be placed on antibiotics for several days.
If the infection is slow to heal, the bursa may have to be drained surgically. To drain the bursa surgically, a small incision is made in the skin, and the bursa is opened. The skin and bursa are kept open by inserting a drain tube into the bursa for several days.
This allows the pus to drain and helps the antibiotics clear up the infection. Prepatellar bursitis that is caused by an injury will usually go away on its own. The body will absorb the blood in the bursa over several weeks, and the bursa should return to normal. If swelling in the bursa is causing a slow recovery, a needle may be inserted to drain the blood and speed up the process.
There is a slight risk of infection in putting a needle into the bursa. Chronic prepatellar bursitis is sometimes a real nuisance. The swelling and tenderness gets in the way of kneeling and causes pain. For people who need to kneel, this creates a hardship both in their occupation and recreational activities. Patients with prepatellar bursitis may benefit from two to four weeks of Physical Therapy.
Surgery is sometimes necessary to remove a thickened bursa that has not improved with any other treatment. Surgical removal is usually done because the swollen bursa is restricting your activity. To remove the prepatellar bursa, an incision is made over the top of the knee either straight up and down or across the knee.
Since the bursa is in front of the patella, the knee joint is never entered. The thickened bursa sac is removed, and the skin is repaired with stitches. You may need to stay off your feet for several days to allow the wound to begin to heal and to prevent bleeding into the area where the bursa was removed. Some types of bursae will probably grow back after surgery, because the skin needs to slide over the kneecap smoothly. The body will form another bursa as a response to the movement of the patella against the skin during the healing phase.
If all goes well, the bursa that returns after surgery will not be thick and painful, but more like a normal bursa. Share this page. This guide will help you understand: how prepatellar bursitis develops why the condition causes problems what can be done for your pain. Where is the prepatellar bursa, and what does it do? In some cases, a direct blow or a fall onto the knee can damage the bursa. This usually causes bleeding into the bursa sack, because the blood vessels in the tissues are damaged and torn.
This can cause the bursa sack to swell up like a balloon. The walls of the bursa may thicken and become tender even after the body has absorbed the blood.
This is known as prepatellar bursitis. People who work on their knees, such as carpet layers and plumbers, can repeatedly injure the bursa. Repeated injuries to the bursa can also cause prepatellar bursitis over a long period of time.
The prepatellar bursa can also become infected. This may occur without any warning, or it may be causes by a small injury and infection of the skin that spreads down into the bursa. In this case, instead of blood or inflammatory fluid in the bursa, it fills with pus.
The area around the bursa becomes hot, red, and very tender. Prepatellar bursitis causes pain and swelling in the area around the front of the kneecap. If the condition has been present for some time, small lumps may be felt underneath the skin over the kneecap.
These lumps are usually the thickened folds of bursa tissue that have formed in response to chronic inflammation. The bursa sack may swell and fill with fluid at times. This is usually associated with increased activity levels.
People who are frequently on their knees, such as carpet layers, develop very thick bursa, almost like a kneepad in front of the knee. Successful nonsurgical treatment of prepatellar bursitis may take 2 weeks or longer.
If left untreated, chronic bursitis may last months or years. Once successfully treated, certain steps can be taken to prevent knee bursitis from returning and becoming chronic. While movement and exercise are essential to overall health, cutting back on activities that irritate the bursa may reduce the chance of a flare-up. Taking periodic breaks from certain activities can also help.
People who spend time on their knees people who install tile and carpet floors, for example may benefit from kneepads. If knee bursitis is associated with an underlying medical condition, such as diabetes or gout, then treating the underlying condition will help prevent future flare-ups.
Knee bursitis is usually successfully treated without surgery or injections. It is important to wait until all knee pain and swelling are gone before resuming normal activities. Returning to activities that irritate the prepatellar bursa before it is healed will likely cause the symptoms to flare up again. Read more about Bursitis Treatment and Prevention. Cortisone Injections Steroid Injections.
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