Bursitis
Bursae are fluid filled sacs present around the joint which facilitate movement and reduce friction at tendon-tendon and tendon-bone interfaces. There are series of bursae around the knee joint
Four bursae anterior to the knee joint:
- suprapatellar bursa
- subcutaneous prepatellar bursa
- subcutaneous infrapatellar bursa
- deep infrapatellar bursa
Two bursae laterally:
- Pes anserine bursa
- between the medial collateral ligament and the capsule, tibia and semimembranosus tendon
Two bursae medially:
- Pes anserine bursa
- between the medial collateral ligament and the capsule, tibia and semimembranosus tendon
Four bursae posterior to the knee joint:
- Medial gastrocnemius bursa
- Semimembranosus bursa or Baker’s cyst
- Lateral gastrocnemius bursa:
- Popliteal bursa
Bursitis is inflammation of these bursae . Most common bursae to get inflamed are those located on anterior and medial aspect of the knee.
Signs and Symptoms
- Knee pain which is sharp in character, develops gradually and can be fluctuating
- May even be present on rest
- May be associated with local swelling and tenderness
- Restriction of motion of knee due to pain, difficulty in flexing and extending knee
Risk Factors
- Prolonged kneeling. People who work on their knees for long periods — carpet layers, plumbers and gardeners — are at increased risk of knee bursitis.
- Participation in certain sports. Sports that result in direct blows or frequent falls on the knee — such as wrestling, football and volleyball — can increase your risk of knee bursitis. Runners can develop pain and inflammation in the pes anserine bursa, situated on the inner side of your knee below the joint.
- Obesity and osteoarthritis.Pes anserine bursitis, affecting the inner side of your knee below the joint, often occurs in obese women with osteoarthritis.
JEEVISHA protocol for management of Knee Bursitis:
- Work ergonomics correction: : Changing the Ergonomics at work place to avoid repetitive frictional movements at knee joint plays a very important role in management of these patients. Expert faculty at JEEVISHA analysis the problems and helps the patient bring changes in their daily life. Patients are also adviced to wear Soft gel knee pads which cushions the knee and reduces pressure on the bursae.
- Medications: In the initial course of the management of this condition, patients may be prescribed some Anti-inflammatory medications. Some other medications may be prescribed depending on the condition of the patient, which is individualized from patient to patient basis.
- Physiotherapy: Physiotherapy, involving stretches of the muscles surrounding the knee joint, plays a very important role in fighting these painful conditions. With a team of dedicated physiotherapist, patient is further evaluated and accordingly a plan is prepared for first reducing pain with different modalities and then slowly rehabilitating shoulder for normal functioning.
Targeted treatment
- Ultrasound guided Bursa aspiration and injections
- Ultrasound guided Platelet rich plasma therapy