A bursa functions like a water balloon to reduce friction and wear of the soft tissues against bone. The prepatellar bursa is a bursa between the patella (kneecap) and the overlying skin. This bursa allows the skin to glide easily and without friction over the patella. Prepatellar bursitis is characterized by inflammation and pain of this bursa.
Initial treatment consists of medication and ice to relieve the pain, stretching and strengthening exercises (particularly the quadriceps and hamstring muscles), and modification of the activity that initially caused the problem. These all can be carried out at home, although referral to a physical therapist or athletic trainer for further evaluation and treatment may be helpful. For those on their knees often or for those at risk of falling and landing on the knees, knee pads should be worn to protect the bursa while the inflammation settles down. An elastic bandage may be used to help reduce swelling. If symptoms persist or recur, withdrawing fluid from the bursa, with or without injection or cortisone, may be needed. Bursae that persist despite conservative treatment, that recur, or that are infected may require surgical excision (removal).
Frequent Signs and Symptoms
- Pain, tenderness, swelling, warmth, or redness over the front of the patella at the prepatellar bursa
- Limited movement in the affected area, occasionally with radiation of pain into adjacent areas
- Occasionally, severe pain with movement of the affected knee
- Crepitation (a crackling sound) when the bursa is moved or touched
- Occasionally, painless swelling of the bursa
- Fever (when infected)
Etiology (Causes)
- Usually, sudden direct trauma or repetitive kneeling or knee bending
- Less commonly, overuse or strenuous, unaccustomed exercise of the knee