Kneecap/Prepatellar Bursitis

Kneecap bursitis, also known as prepatellar bursitis, involves the inflammation of the bursa, a small sack of fluid located in front of the kneecap, known as the patella. When this bursa is irritated, it can produce too much liquid, causing it to inflame and press on other structures of the knee. The bursa is located between the kneecap and skin, so when it inflames, it can cause significant pain and discomfort leading to reduced range of motion.

The Causes of Prepatellar Bursitis

Most cases of prepatellar bursitis are caused by pressure on the kneecap. Typically, jobs that require pressure on the knees, such as kneeling, put the individual at highest risk. However, prepatellar bursitis can also occur with injury to the kneecap. Whether the injury occurs due to an accident or an athletic injury, the outcome is often very similar in the form of swelling and dysfunction of the knee. Athletes who play contact sports, such as football, also have a significantly higher risk than those playing noncontact sports. Patients with rheumatoid arthritis and gout may also have a higher risk of this condition. Prepatellar bursitis can also be caused by an infection due to bacteria entering a wound in the knee. This is not as common as injury-related prepatellar bursitis but represents a more urgent need for treatment.

Signs and Symptoms

Depending on the degree of swelling, the signs and symptoms of prepatellar bursitis may be alternately subtle or very obvious. Most patients will experience some pain the more active they are. This usually subsides as the activity does and at night when the patient is resting. Patients may also see significantly swelling at the front of the knee. Since there is not much fat or musculature there, the swelling can be very obvious and quite alarming. Along with this swelling, there may be some pain and warmth, even some redness if the bursitis is bacterial in cause.

Diagnosing Prepatellar Bursitis

Dr. Manning will perform a complete physical and medical evaluation of the knee as well as understanding any circumstances that may have contributed to a knee injury. This will include checking for swelling, tenderness and other signs of bursitis. In some cases, an x-ray, MRI or CT may be ordered if Dr. Manning believes that there is a more serious underlying injury.

Treatment for Prepatellar Bursitis

Many cases of prepatellar bursitis can be treated conservatively with rest, ice, elevation and anti-inflammatory medications such as ibuprofen (Advil/Motrin) or naproxen (Aleve). A bacterial infection will require a course of antibiotics and the potential for drainage of the bursa, if antibiotics are not sufficient to reduce the inflammation.

In cases where the inflamed bursa does not respond to conservative treatment, the additional fluid in the bursa may need to be removed through a process known as aspiration, using a very fine needle. Corticosteroid will then be injected into the bursa to minimize the risk of the inflammation returning.

In rare cases, the entire bursa may have to be removed surgically, known as a bursectomy. This is necessary only if none of the treatment options mentioned above are sufficient to reduce the inflammation and restore the knee’s normal function.

To learn more about this and other knee-related conditions and for a proper diagnosis and treatment options, we look forward to scheduling you for a consultation with Dr. Manning.

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