Sports Medicine Knee Inflammation

Pre-patellar Bursitis

What is a Pre-patellar Bursitis?
Pre-patellar bursitis is inflammation of the bursa, which sits between the patellar tendon and the skin. A bursa is a fluid-filled sac that sits between muscle and skin and acts as a cushion. When the bursa becomes inflamed, it swells and becomes thicker. This causes pain and swelling in the front of the knee. The inflamed area may become infected, requiring additional treatment.

What causes Pre-patellar Bursitis?
Pre-patellar bursitis can occur from trauma to the anterior aspect of the knee, or from chronic kneeling. Another term for pre-patellar bursitis is housemaid’s knee, as it is commonly seen in people who spend a lot of time kneeling and squatting.

What are the symptoms?
Pain and swelling in the front of the knee. If it becomes infected, the patient may complain of fevers, drainage from the front of the knee, redness and tenderness to the touch.

How is Pre-patellar bursitis diagnosed?
Your surgeon will take a careful history and perform a physical exam. X-rays are generally negative.

How is it treated?

Non-operative
Your surgeon will prescribe anti-inflammatory medication to reduce the swelling, and may offer to drain fluid from the bursa. Rest, ice, compression and elevation will help bring the swelling down. Avoiding the kneeling position is key to recovery, and where possible, patients should wear kneepads to prevent recurrence.

Operative
For patients who fail non-operative treatment, or who go on to develop chronic inflammation, the bursa can be excised through an anterior incision in the knee.

Patellar Tendonitis

What is a Patellar Tendonitis?
Patellar tendonitis is inflammation of the tendon that connects the kneecap to the leg bone.

What causes Patellar Tendonitis?
Patellar tendonitis results from overuse or from a direct blow to the anterior knee. Another name for Patellar Tendonitis is ‘Jumper’s knee’, as it occurs frequently in athletes who play jumping sports such as basketball and volleyball.

What are the symptoms?
Patients complain of pain in the front of the knee just below the kneecap. The pain is activity related, and is commonly associated with squatting, running or using stairs. There is sometimes swelling in the joint.

How is Patellar Tendonitis diagnosed?
Tenderness to the touch on physical exam is a sign of patellar tendonitis. X-rays are usually normal, but may show an abnormally positioned kneecap, which puts patients at risk for developing pain in the knee.

How is it treated?

Non-operative
Your surgeon will prescribe anti-inflammatory medication and avoidance of painful activities. The knee may be immobilized to allow the tendon to rest. A strap worn over the patellar tendon may reduce pain by taking stress off of the tendon’s attachment site. Physical therapy may be beneficial. High frequency ultrasound has been used successfully to treat this condition.

Operative
Operative treatment for patellar tendonitis is seldom indicated, as most patients will respond to non-operative treatment. If an operation becomes necessary, the surgeon makes several longitudinal splits in the tendon and drills into the kneecap to encourage bleeding from the bone. The drill holes allows bone marrow to leak into the lesion bringing with it blood cells that are capable of healing the damaged tendon.

Quadriceps Tendonitis

What is a Quadriceps Tendonitis?
Quadriceps tendonitis is inflammation of the tendon that connects the muscles of the thigh to the kneecap.

What causes Quadriceps Tendonitis?
Quadriceps tendonitis results from overuse or from a direct blow to the anterior knee.

What are the symptoms?
Patients complain of pain in the front of the knee just above the kneecap. The pain is activity related, and is commonly associated with squatting, running or using stairs. There is sometimes swelling in the joint.

How is Quadriceps Tendonitis diagnosed?
Tenderness to the touch on physical exam is a sign of quadriceps tendonitis. X-rays are usually normal.

How is it treated?

Non-operative
Your surgeon will prescribe anti-inflammatory medication and avoidance of painful activities. The knee may be immobilized to allow the tendon to rest. Physical therapy may be beneficial. High frequency ultrasound has been used successfully to treat this condition.

Operative
Operative treatment for quadriceps tendonitis is seldom indicated, as most patients will respond to non-operative treatment. If an operation becomes necessary, the surgeon makes several longitudinal splits in the tendon and drills into the kneecap to encourage bleeding from the bone. The drill holes allows bone marrow to leak into the lesion bringing with it blood cells that are capable of healing the damaged tendon.