Prepatellar bursitis (housemaid's knee) Dr Rob Hicks Modern appliances may have meant the end of knee problems for most of those involved in cleaning or housekeeping, but that doesn't mean 'housemaid's knee' no longer exists.

In this article

What is it? What causes it?

Can it be prevented? What's the treatment?

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.

One, 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.

Inflammation causes the bursa to become tender and swollen. As a result it may be difficult and painful to move the joint.

A possible complication is that the fluid within the bursa becomes infected. When this happens, the area may 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 it.

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.

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, while 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 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 may be necessary.

This article was last medically reviewed by Dr Rob Hicks in July 2006.