How is prepatellar bursitis (housemaid's knee) treated?

Updated: Sep 15, 2020
  • Author: Divakara Kedlaya, MBBS; Chief Editor: Dean H Hommer, MD  more...
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Conservative Management:

Conservative management consists of protection, rest, ice, compression, and elevation (PRICE); nonsteroidal anti-inflammatory drugs (NSAIDs); and bursal aspiration. Intrabursal steroid injection may be indicated for the treatment of chronic NSB. For acute SB, antibiotic therapy is the key treatment and should be started as soon as infection is suspected after the bursal fluid aspiration. Transient immobilization of the knee in the neutral position with a posterior splint may be needed in cases of acute prepatellar SB. [9]

Physical therapy

After the initial period of rest, the goal of physical therapy is to regain any loss of range of motion (ROM) while increasing the flexibility of the quadriceps and hamstrings. Use of therapeutic modalities can be helpful to assist stretching in this period.

Occupational therapy

The role of the occupational therapist in this scenario is to address modifications of activities in patients diagnosed with prepatellar bursitis secondary to overuse. Emphasize patient education, avoidance of kneeling, and use of kneepads if kneeling is necessary.

Surgical intervention:

Incision and drainage of the prepatellar bursa usually is performed when symptoms of acute SB have not improved significantly within 36-48 hours of antibiotic administration. Surgical removal of the bursa (ie, bursectomy) may be necessary for chronic or recurrent prepatellar bursitis. [10] Arthroscopic or endoscopic excision of the bursa has been reported to have satisfactory results, with less trauma than open excision. [11, 12]

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