Infrapatellar bursitis is a condition that causes pain and swelling below the kneecap. It occurs when one of the infrapatellar bursa becomes inflamed, either due to repetitive strain or from a direct impact. Treatment for this sort of bursitis involves resting the injured joint as well as controlling swelling with cold therapy and anti-inflammatory medication. Sometimes a cortisone injection may be recommended if conservative treatment fails. Surgery to remove the bursa is seen as a last resort, but is an option if other treatments are ineffective.
Bursa are small fluid sacs that are located in joints around the body. They help to lubricate joints and stop tendons from rubbing on bone. There are two infrapatellar bursas located above and below the tendon beneath the kneecap. They are known as the deep infrapatellar bursa, found beneath the patella tendon, and the superficial infrapatellar bursa, located above the tendon. If one becomes inflamed due to injury, this is known as infrapatellar bursitis.
There are several potential causes of infrapatellar bursitis. Repetitive friction of the bursa, which is the most common cause, can result in inflammation and pain. The condition is sometimes known as “Clergyman’s knee” because the bursa can be irritated by kneeling for long periods of time. Infrapatellar bursitis can also be the result of a direct impact injury to the region, although this is less common.
The main symptom of infrapatellar bursitis is pain at the front of the knee below the kneecap. This pain often gets worse when the knee is put under stress. Sometimes a person suffering from infrapatellar bursitis may notice swelling around the area of the injury. Pain in this location is often mistaken for patella tendinitis, a condition caused by inflammation in the patella tendon, so it’s important to get an accurate diagnosis before treatment begins.
Treatment for infrapatellar bursitis starts with relative rest, which means avoiding all activities that cause pain. The patient should try to avoid kneeling or putting pressure on the area around the bursa as this can delay healing. Nonsteroidal anti-inflammatory drugs (NSAIDs) and cold therapy can be useful for reducing swelling and inflammation.
In some cases, conservative treatment for infrapatellar bursitis is ineffective. If rest, cold therapy, and NSAIDs all fail to resolve the pain, a doctor may recommend aspirating the bursa. This involves removing fluid and injecting cortisone to reduce inflammation. Surgery is rarely required in all but the most severe and difficult cases.