Knee Bursitis

Knee bursitis can affect different bursae, such as:

• Prepatellar bursitis when the bursa in front of the kneecap becomes inflamed, often called “housemaid’s knee”.
• Infrapatellar bursitis when the bursa below the kneecap is irritated, sometimes called “clergyman’s knee”.
• Pes anserine bursitis when the bursa on the inner side of the knee, just below the joint, is inflamed.
• Septic bursitis when infection causes inflammation of the bursa.

Knee bursitis may develop from:

• Prolonged kneeling or pressure on the knees
• Overuse or repetitive movement of the knee joint
• Direct blows or injuries to the knee
• Bacterial infections
• Underlying medical conditions such as osteoarthritis, rheumatoid arthritis, or gout.

Certain factors increase the chances of developing knee bursitis:

• Extended pressure on the knee from jobs such ascarpet laying, plumbing, or gardening.
• Repetitive knee strain from sports like wrestling and football or running.
• Underlying health conditions, such as bacterial infections, osteoarthritis, rheumatoid arthritis, gout, or obesity.

Based on the bursa involved and the underlying cause of inflammation, the following may be noted: 

• Common symptoms include warmth, soreness, swelling, and pain while moving or resting the knee.
• Sudden symptoms may occur after a direct hit.
• Kneeling on hard surfaces can cause chronic symptoms.
• Fever, bruising, swelling and skin changes near the knee, along with difficulties moving the knee, may also be observed.

• Reviewing medical history.
• Conducting physical examinations.
• Performing imaging tests (e.g., X-ray, MRI, and/or ultrasound) or fluid aspiration.

Depending on the severity of symptoms, one or more of the following approaches may be recommended for treating knee bursitis:

• Non-surgical treatment
  • Rest, ice packs, compression, and elevating the leg to decrease swelling.
  • Over-the-counter painkillers or prescribed anti-inflammatory medicines.
  • Antibiotics if a bacterial infection in present.
  • Physiotherapy to strengthen the muscles supporting the knee and improve flexibility.
  • Weight management if excess weight puts pressure on the knees
• Surgical treatment
  • Corticosteroid injections to reduce inflammation.
  • Aspiration to drain excess fluid from the swollen bursa.
  • Surgery to remove the bursa, which is rare and only done if other treatments fail.
  • Post-treatment physiotherapy to restore movement and prevent reinjury. 

Patients are advised to consult a doctor if:

• Knee pain and swelling do not improve with rest and home care.
• The knee feels warm, red, or tender, which may signal infection.
• You develop fever along with knee pain.
• The swelling becomes severe or keeps returning.

You can help prevent knee bursitis by:

• Wearing kneepads when working or exercising on hard surfaces.
• Taking regular breaks from kneeling or repetitive activities.
• Maintaining a healthy body weight.
• Warming up before sports and practising stretching exercises.
• Strengthening the thigh and leg muscles to support the knee joint.

For diagnosis and treatment of knee bursitis, you should consult an orthopaedic doctor. A physiotherapist may also be involved in rehabilitation and exercises to restore mobility and prevent recurrence.