Prepatellar Bursitis Causes, Symptoms & Treatment Options

Overview

Several thin, jelly-like sacs called bursae sit around the knee and help limit friction between bone, skin, and nearby tissues. When the bursa in front of the kneecap becomes inflamed or irritated, it leads to prepatellar bursitis. The area may appear swollen, warm, and tender. Many people notice discomfort when kneeling, touching the front of the knee, or bending the joint many times.

 

The condition may begin suddenly after a fall or direct impact, though it can also develop gradually from repeated pressure or frequent kneeling. Because this bursa lies close to the surface, it becomes irritated easily, especially in those whose work or activities place steady weight on the front of the knee.

What causes Prepatellar Bursitis?

Prepatellar bursitis can develop for several reasons. A direct impact to the knee, common in sports like football, basketball, and wrestling, can irritate or injure the bursa. Repeated minor stress from constant kneeling or frequent knee bending also contributes to inflammation. People who work on their knees, such as plumbers, electricians, carpet installers, and gardeners, often experience prolonged pressure on the kneecap, which increases their risk. Sudden falls that bruise or irritate the Prepatella bursa  can also lead to this condition, and in rare cases, an infection within the bursa may be the cause. Overall, individuals who kneel on hard surfaces or participate in high-impact activities are more likely to develop prepatellar bursitis.

1. How the Injury Occurs: The injury occurs when the bursa becomes inflamed due to irritation, pressure, or repeated impact. The bursa fills with fluid, creating swelling on top of the kneecap. This swelling makes the knee painful and sensitive to touch.

2. Common Everyday Causes:

• Kneeling for long periods while cleaning, gardening, or doing repairs 
• Repetitive bending of the knee during work or workouts 
• Falls or slipping accidents that hit the front of the knee 
• Wearing poor-quality padding during sports or physical labor 

Sports Associated With Prepatellar Bursitis

Prepatellar bursitis often occurs in contact sports or activities that place frequent stress on the kneecap:

• Rugby – tackles and frequent falls place steady pressure on the kneecap 
• Wrestling – close contact with firm mats can irritate the bursa 
• Football – direct blows to the knee may lead to swelling
  
• Volleyball – diving or landing on the knees increases stress on the area

Symptoms

Prepatella  bursitis may cause the following signs and symptoms:

• Pain and swelling on top of the knee 
• Redness and warmth over the kneecap 
• Tenderness when kneeling or pressing on the knee 
• A puffy appearance around the kneecap 
• Ability to walk, run, or jump normally, but with visible swelling 
• Discomfort that worsens with climbing stairs or bending the knee 

Most people can still move the knee normally, but pressure on the area can be painful.

Non-operative treatment

If symptoms continue, your doctor will examine the knee and compare it with the healthy side. They will look for swelling, tenderness, warmth, and changes in movement. Most people with prepatellar bursitis keep a full range of motion because the inflamed bursa does not interfere with how the joint moves.

A diagnosis is usually made through a physical exam and a review of your symptoms. Imaging, such as X-rays, is seldom needed unless there is concern about another injury, such as a fracture. If the knee is warm, red, or draining fluid, your doctor may take a small sample from the bursa to check for infection.

Your treatment plan may include gentle exercises to ease stiffness and support recovery.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Prepatellar Bursitis

Surgical Treatment

Surgery is rarely needed for prepatellar bursitis. If rest, ice, and anti-inflammatory medications do not provide sufficient relief, your doctor may consider the following options:

Aspiration

A needle can be used to drain fluid from the bursa. This procedure often provides quick relief, though fluid may return, sometimes requiring repeated drainage.

Bursa Removal (Bursectomy)

In a small number of cases, the bursa may be surgically removed if it remains persistently swollen or becomes infected. The surgeon makes a small incision over the front of the knee to remove the affected tissue. During recovery, the body typically forms a new, healthy bursa naturally.