Housemaids knee or prepatellar bursitis: What can you do about it?

Housemaids knee, also known as prepatellar bursitis or kneecap bursitis, causes swelling and pain at the front of the knee. So why is it called housemaids knee, and what can you do about it?

What is housemaids knee?

Housemaids knee is a swelling in the sac at the front of the knee called the prepatellar bursa. This sac sits on top of the knee cap. The prepatellar bursa is one of four bursae in the knee. Less frequently, other bursae are affected, and bursitis in the knee.

What causes housemaids knee?

Causes of prepatellar bursitis include:

a fall on the knee.
Repeated minor injury occurs when kneeling on the knee for long periods. This kneeling is typical for housemaids; hence we use the term housemaids knee. However, other workers such as carpenters, plumbers, and rugby players are also at risk.
Infection. A break in the skin can lead to infection in the bursa causing pain and swelling.

Housemaids knee symptoms

Prepatellar bursitis causes pain and swelling at the front of the knee. Pain and swelling from prepatellar bursitis can occur suddenly or gradually. Pain occurs with kneeling or other direct pressure. Often, people describe sharp needle-like pain when kneeling. Also, stiffness of knee movements and general tightness are common. In cases of infection, the skin is hot to touch, and you may feel unwell with a fever.

Also, it is common to have an indent in the knee dues to swelling.

Your doctor should rule out other causes of knee pain and swelling, such as runner’s knee, cartilage damage in the knee, or another knee bursitis such as infrapatellar bursitis.

Investigations such as ultrasound or MRI are helpful to help with the diagnosis of housemaids knee and rule out other causes.

How do you treat kneecap bursitis?

Generally, treatment depends on the cause.

In infective prepatellar bursitis, we suggest high-powered antibiotic tablets. Sometimes, patients need to be in hospital for intravenous antibiotics. Occasionally, you may need surgery to remove the infection.

In non-infectious prepatellar bursitis, simple treatments are usually adequate. Firstly, avoiding activities that aggravate bursitis, such as kneeling, can be helpful. Secondly, knee padding and stretches for bursitis can protect the knee from further friction. Finally, anti-inflammatory tablets such as ibuprofen can reduce inflammation.

Sometimes, in cases that don’t settle with simple treatments, you may be offered a cortisone shot as the next step for kneecap bursitis.

How long does Housemaids knee last?

Generally, kneecap bursitis lasts from weeks to months and may recur if irritation from kneeling persists. Overall, however, symptoms gradually improve with treatment.

More about a cortisone shot for Housemaids knee

Cortisone is a powerful drug that reduces inflammation. Pre-patellar bursitis is an inflammatory condition, so it makes sense that we would inject cortisone into this bursitis to make it better.

Generally, injections should be performed with ultrasound to improve accuracy and effectiveness. Also, ultrasound allows the doctor to confirm the correct diagnosis and avoid injecting wrong structures such as knee tendons. However, injecting cortisone with ultrasound can introduce infection, so you need to be careful. Therefore, we suggest you ask these four questions before having an ultrasound-guided injection.

Initially, we used a numbing shot such as lidocaine. Then, we drain fluid from the bursa using a needle under ultrasound. Finally, a small dose of cortisone is injected into the knee bursitis to stop the fluid from coming back. After the cortisone shot for housemaids knee, we apply pressure to the front of the knee to prevent it from coming back. Also, it is essential to wear a protective sleeve or knee padding to protect it from further friction.

Patients might need surgery to remove the bursa if all other treatments fail in rare cases.

Final word from Sportdoctorlondon about prepatellar bursitis

Prepatellar bursitis is a common but benign condition that is more nuisance than serious. Simple treatments such as ice, compression, and knee padding will often help. However, a cortisone shot might help stubborn cases.