Pre-patella bursitis (aka housemaid’s knee) causes a swelling that over the front of the patella that can be erythematous (red), tender to touch and cause tightness or limited movement of the knee.
What causes it?
The bursa usually occurs following prolonged pressure on the front of the knee after kneeling or an impact. As a result, the bursa that allows the tissue to glide over the front of the knee swells and as it does so causes the pain, tightness and limited movement.
How can I help myself?
First and foremost, it is important to consider what activity brought on the symptoms and try to offload from this. It may be from kneeling during your sport or even from changing your baby’s nappies!
If symptoms are acute with swelling and redness, simple PRICE measures can help reduce these and pain can be addressed by using oral or topical analgesia such as anti-inflammatories.
When to seek help?
If your symptoms are ongoing despite trying these measures, or if the swelling and limitation is getting worse, it may be a good idea to have the knee assessed when possible.
What are the treatment options?
Your clinician will initially assess you with a thorough history and examination. Having done so, they may organise an X-ray to see if the swelling is due to a bony injury to the patella or perform an ultrasound scan to assess the bursa.
Generally this problem will settle with sufficient offloading and time, but if symptoms are progressive or limiting your activity, then the swelling can be drained and a small amount of sclerosing (scarring) substance or cortisone can be injected to help keep it closed.
Compression afterwards is also important and this will help to keep the sides of the swelling together. Surgical intervention is not usually required for this but if the bursa keeps recurring and causing trouble, your clinician may request this.