Orthopedics Hip & Knee Kneecap (Patella) Conditions Prepatellar Bursitis of the Kneecap Symptoms and Treatment By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on February 13, 2020 Medically reviewed by Stuart Hershman, MD Medically reviewed by Stuart Hershman, MD LinkedIn Stuart Hershman, MD, is a board-certified spine surgeon. He specializes in spinal deformity and complex spinal reconstruction. Learn about our Medical Expert Board Print Prepatellar bursitis, also known as housemaid's knee, is a common cause of swelling and pain on top of the kneecap. The name "housemaid's knee" comes from the association of this condition with individuals whose work necessitates kneeling for extended lengths of time. Prepatellar bursitis is common in professions such as carpet layers and gardeners. Patrik Giardino / Getty Images A bursa is a thin sack filled with the body's own natural lubricating fluid. This slippery sack allows different tissues such as muscle, tendon, and skin slide over bony surfaces without friction. These bursa are normally very thin (like a plastic bag with the air sucked out of it), but they are a potential space that can become swollen and inflamed. This is what is known as bursitis. The primary concern with prepatellar bursitis is that the bursa can often become infected. In fact, of all the common types of bursitis, prepatellar bursitis is the most commonly infected type. Usually, the infection comes from some penetration through the skin which may be a scrape, an abrasion, or a deep cut. The most common type of infected prepatellar bursitis is a Staph infection. Causes Pressure from constant kneeling on the job is the traditional cause. Carpet laying, plumbing, gardening, and agricultural jobs may be risks. It can also be caused by a blow to the kneecap during sports or smacking it during a fall. Symptoms The symptoms of prepatellar bursitis include: Swelling over the kneecap Limited range of motion of the knee Painful movement of the knee Redness on the front of the knee The swelling of knee bursitis is within the bursa, not the knee joint itself. People often call any swelling of the knee joint "water on the knee," but it is important to differentiate fluid accumulation within the bursa versus fluid accumulation within the knee joint. Treatment Treatment of prepatellar bursitis begins with avoiding the aggravating activity. Other commonly used treatments include anti-inflammatory medications, ice application, and compression wraps. When there is significant accumulation of fluid in the bursa, consideration can be given to remove the fluid by draining the bursa with a needle and syringe. If the fluid is drained from the bursa, analysis of this fluid can be performed if there is a question of infection. If there is no concern for infection, often a cortisone injection will also be administered to hopefully prevent the fluid from coming back. Patients who do have an infection of their bursa require additional treatment. There is debate about the best treatment, and it likely depends on the severity of the infection and the individual patient to know the best treatment. Options may include oral antibiotic treatment, intravenous antibiotics, or surgery to remove the infected bursa. Usually if an infection is detected quickly, simple treatments will begin, whereas more aggressive, advanced infections may require a surgical procedure to clean the infection to prevent it from spreading. 3 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Baumbach SF, Lobo CM, Badyine I, Mutschler W, Kanz KG. Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm. Arch Orthop Trauma Surg. 2014;134(3):359-70. doi:10.1007/s00402-013-1882-7 Prepatellar (Kneecap) Bursitis, American Academy of Orthopaedic Surgeons, March 2014. Parker CH, Leggit JC. Novel Treatment of Prepatellar Bursitis. Mil Med. 2018;183(11-12):e768-e770. doi:10.1093/milmed/usy098 Additional Reading Aaron DL, et al. "Four Common Types of Bursitis: Diagnosis and Management" J Am Acad Orthop Surg June 2011; 19:359-367. Huang YC, Yeh WL. Endoscopic treatment of prepatellar bursitis. Int Orthop. 2011;35(3):355-8. doi:10.1007/s00264-010-1033-5 By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit