Prepatellar bursitis (housemaid's knee) Dr Rob Hicks Inflammation causes the knee to become tender and swollen, making it difficult and painful to move the joint.

In this article

What is prepatellar bursitis? Symptoms

Causes and risk factors Treatment and recovery

The knee has 15 bursae, fluid-filled sacs that act as shock absorbers and protect the bones, joints and tendons from the harm friction can cause.

The prepatellar bursa, is located in front of the kneecap (patella). When this becomes inflamed, as the result of repeated friction between the skin and patella, it's known as prepatellar bursitis.

Along with the bursa becoming tender and swollen, complications can arise when fluid within the bursa becomes infected, causing the area to become red, hot and painful.

Friction between the skin and the patella can be caused by someone spending a lot of time on their knees, doing repetitive movements. Inflammation can also occur as the result of injury, infection or an underlying inflammatory condition.

However, often it's not clear why someone has developed a prepatellar bursitis.

Rest is one of the most important treatments. Cold and heat therapy can also be used to relieve inflammation:

• A bag of frozen vegetables wrapped in a tea towel is a simple means of providing cold therapy.
• A hot water bottle wrapped in a towel is an effective form of heat therapy.
• Alternating hot and cold water from a showerhead is another idea.

Painkillers and anti-inflammatory medication such as ibuprofen are also usually recommended.

Persistent fluid accumulation in the bursa increases the risk of further episodes of inflammation. Under these circumstances, the fluid may need to be aspirated, and hydrocortisone may be injected to relieve any inflammation and prevent further fluid accumulation.

If the problem persists despite these measures, surgical excision of the bursa may be necessary.

The best way to avoid inflammation of the bursa is to steer clear of any action that causes repeated friction between the skin and patella.

In some occupations, such as carpet-fitting, this may not be possible, although it's not unheard of for people to change profession because of recurring knee problems.

This article was last medically reviewed by Dr Trisha Macnair in July 2009.