Bursitis of the knee joint - symptoms and treatment at home. Symptoms and treatment of knee bursitis Bursitis of the knee surgical treatment

Prepatellar bursitis is a pathology that is characterized by inflammation of the articular bag of the knee joint and tissue damage. The bursa is a small sac that is located between the kneecap and the skin, filled with fluid. Pain in the affected area is the main symptom of bursitis.

There are several types of bursitis, which are differentiated depending on the type of joint bag involved in the process.

The fact is that in the knee, in addition to the prepatellar bag, there is also a suprapatellar bag. This bag is located at the junction of the knee cartilage. The inflammation of this bag has its own name - suprapatellar bursitis. However, despite the difference in name and localization, the symptoms of the diseases are the same.

Causes

The most common causes of knee bursitis are:

training with an increased risk of injury;

the patient has concomitant infectious diseases (gonorrhea, brucellosis, tuberculosis, syphilis);

infections at the site of abrasions or cuts on the knee;

falling to your knees, directed blow;

prolonged or constant physical activity, which involves the involvement of the knee joints in this process and puts a lot of pressure on the knees.

The development of inflammatory processes in the knees is typical not only for athletes. Each person can face such a problem after receiving even a minor injury:

In 2011, the famous singer Barry Manilow underwent surgery due to complicated prepatellar bursitis.

In 2013, famous Hollywood actor Tom Hanks also underwent surgery for knee bursitis. In addition, he even filmed the treatment process on video.

Bursitis of the knee joint is classified:

according to the nature of the exudate:

• fibrous bursitis - a high content of fibrous tissue;

  purulent - the presence of destroyed microorganisms, cells, decayed leukocytes;

  serous - the fluid contains plasma with blood cells;

  hemorrhagic bursitis - the fluid contains a large number of red blood cells;

by pathogen: specific (for brucellosis, syphilis, gonorrhea, tuberculous bursitis) and non-specific. In this classification, aseptic and infectious bursitis can be subdivided;

according to the clinical course: acute, subacute, chronic bursitis.

Symptoms

The main symptoms that characterize knee bursitis are gradually increasing pain and swelling in the area in front of the kneecap. Less severe cases may develop without swelling, and the patient begins to feel stiffness in the joint during prolonged physical activity. At the initial stage of the pathological process, pain can subside as blood circulation improves, that is, on the contrary, with moderate physical exertion.

Other signs:

swelling, increased local temperature, redness, induration in the area of ​​the knee joint;

pain when walking, especially when going up or down an incline;

pain from touch in the area of ​​the kneecap;

inability to straighten the leg normally at the knee.

Pain occurs just above the kneecap, after which it can spread to the inner thigh or back of the knee, as well as up and down the entire leg. The pain intensifies when trying to cross the legs, and also after getting up, if before that the patient had been sitting in one position for a long time. A person who has prepatellar bursitis cannot kneel on their own.

An indirect symptom of knee bursitis is sleep disturbance. Pain when changing body position or bending the leg can increase significantly regardless of the degree of inflammation, which leads to such a symptom. Many patients, based on experience, recommend placing a pillow between the thighs at night.

Restriction of mobility appears with the progression of the pathology, when the inflammation becomes very pronounced and simple bending of the leg leads to severe pain. Over time, dystrophy and muscle weakness of the affected limb develops.

For acute bursitis:

swelling is formed in the area of ​​the bag, elastic, painful, rounded;

there is pain, redness and swelling of soft tissues;

there is a restriction in the movement of the joint;

the temperature rises, malaise may occur;

the pain intensifies, the redness expands, and the temperature can reach up to 40 degrees;

development of phlegmon, purulent process is possible.

Correct and timely treatment of the acute form of bursitis can stop the progression of the disease and does not allow it to go into a subacute or chronic state.

For chronic bursitis:

the motor abilities of the joint are not limited;

a rounded soft swelling appears in the area of ​​​​the bag;

there is no swelling, redness and pain;

a relapse is possible in a chronic process (due to a decrease in immunity, trauma).

Types of bursitis

Prepatellar bursitis is the most common type of bursitis, in which the subcutaneous bursa in front of the knee becomes inflamed. The cause of such bursitis can be rheumatoid arthritis, salt deposition in pseudogout, gouty arthritis, it can also develop with injuries, bruises, falls on the knee, if the work requires long kneeling. Compared to arthritis, the movement restrictions are minor and the pain is not as severe. When the contents of the bursa are infected, body temperature may increase, pain may increase, and lymph nodes may increase.

Infrapatellar bursitis is an inflammation of the bursa, which is located under the tendon, which is located under the kneecap. Most often, this type of bursitis develops after injuries or jumps. Treatment consists of rest, taking painkillers and NSAIDs, cold compresses.

Baker's cyst (goose bursitis) - with this type of pathology, the bursa becomes inflamed, which is located on the inner surface of the knee joint. Most often occurs in women who are overweight. Accompanied by pain that becomes more pronounced when climbing or descending stairs.

Treatment

Most cases of knee bursitis are treated with physical therapy. A positive result of treatment directly depends on the participation of the patient. One of the main components of treatment is to provide the body with sufficient rest after any type of physical activity, if it has led to increased pain.

If physiotherapy causes a deterioration in the condition, the possibility of a tuberculous etiology of the disease should be excluded, because physiotherapy, thermal procedures, massage leads to deterioration and further progression of the disease in the presence of extrapulmonary forms of tuberculosis.

Activities that irritate the bursa of the knee joint should be minimized. If the patient feels that he can perform such activities and they do not cause pain, the gradual restoration of activity means that the disease does not progress, and the patient's condition begins to improve.

Ignoring the symptoms and trying to adapt to pain is unacceptable, as this can lead to the transition of the disease to a chronic form. It is important to start treatment as soon as possible, regardless of the patient's condition and the severity of the disease.

When the disease becomes chronic, the recovery process noticeably slows down, and the likelihood of a relapse in the future increases significantly.

The initial phase of treatment for knee bursitis involves the following regimen: Ice - Rest - Pressure - Lift. This mode allows you to achieve a significant improvement in the condition, provided that the activities will be started within the first 3 days after the injury.

Gentle mode means:

maintaining the diseased limb in a position above the level of the heart (raised);

the use of compressive elastic bandages;

regular cooling of the area of ​​​​inflammation with ice;

limitation of loads that can lead to deterioration.

Therapy with anti-inflammatory drugs, which have a decongestant and analgesic effect, can speed up the recovery process.

Manual therapy can also improve the course of the disease, these are:

electrotherapy;

stretching;

acupuncture;

With the correct implementation of physiotherapy exercises and procedures, most cases with mild manifestations of the disease are cured within a few weeks with the restoration of the normal functioning of the joint. In the case of more severe or chronic forms, the recovery process may take significantly longer.

In this case, there is a high probability that the patient may require additional therapy (corticosteroid injections). Early initiation of physiotherapy is necessary to achieve an optimal outcome of the disease, accelerate the healing process and reduce the likelihood of re-development of such a pathology.

Exercises

Special exercises play an important role in the treatment process:

Static contractions of the internal head of the quadriceps muscle

Tighten the quadriceps femoris muscle by bringing a towel roll under the knee joint and trying to straighten the leg. Place your palm on the inside of your thigh to feel the tension in the muscle during contraction. Next, fix your leg in this position for 5 seconds, then relax. The exercise should be repeated 10 times, straining the leg as much as possible, however, without leading to the appearance of pain.

Flexion and extension of the leg at the knee

Without leading to the appearance of pain, it is necessary to bend and unbend the leg at the knee with a maximum range of motion. The exercise should be repeated 10-20 times, if during the execution there is no increase in the symptoms of the disease.

From the training program, crossing the legs, repetitive bending of the knee joints, squats and other similar exercises should be excluded.

Surgical treatment

In the absence of the effect of conservative treatment of knee bursitis, an operation may be required, which consists in suctioning fluid from the joint capsule and introducing corticosteroids into the bursa.

This procedure is performed using a thin needle and under local anesthesia. After draining, the doctor decides on the need for the introduction of hormonal drugs. They are necessary to eliminate the inflammatory process. After the operation, it is necessary to provide the limbs with prolonged rest (about 48 hours) and continue wearing the elastic bandage. This treatment has a much better effect compared to non-steroidal anti-inflammatory drug therapy, since drugs in the form of tablets have a greater effect on the entire body, and may not penetrate into the joint.

There are also cases, quite rare, when any treatment methods are ineffective, and then the only treatment option is the removal of the prepatellar bag of the joint. The restoration of the normal functioning of the joint occurs after a few days, and the patient can return to a full life without restrictions from physical activity in 2-3 weeks.

Antibiotics

With an infectious origin of bursitis of the knee joint, to prevent the development of purulent processes and complications, antibiotic therapy should be started as soon as possible. The doctor selects drugs based on the sensitivity of the pathogen. If the disease continues to progress after the start of treatment, the joint capsule is opened and cleaned using surgical methods.

Ointments for local treatment

To relieve pain, inflammation, swelling and improve the condition, in addition to kneecaps, ointments containing anti-inflammatory components can be used:

Ointments with menthol (Ben-Gay, Bom-Benge) - have an anti-inflammatory effect with a distracting cooling effect.

Finalgon and its analogues - contribute to the removal of edema, improve blood circulation in the treated area.

Nise-gel, Fastum-gel - very quickly relieves swelling, has an analgesic effect. Produced drugs based on non-steroidal anti-inflammatory drugs.

Knee padKnee Inferno Wrap

This knee brace is a novelty in the market of assistive devices for the treatment of knee bursitis. The device stimulates local blood flow with the help of radiation in a certain spectrum, the range of emitted light is close to the sun's rays. This contributes to the production of additional energy that the patient's body receives. In the future, this energy is used to enhance recovery processes.

The device has a local effect and promotes the rapid removal of toxins and dead cells, accelerates the processes of tissue regeneration and increases their elasticity.

Prevention

There are several tips that are aimed at preventing the development of such an unpleasant disease:

After training, give your legs an elevated position and apply ice.

Give your feet regular rest. Alternate the intensity and types of physical activity to avoid prolonged stress.

Wear knee pads. For people who are at an increased risk of injury (wrestlers, basketball players, soccer players), this is especially important. Today, there are special cooled knee pads that have ice pockets.

The knee joints carry the load of the human body and are often affected by trauma, infectious or systemic diseases. The peculiarity of their structure and functioning leads to the appearance of pathological signs of various localization.

Causes

Pathologies of the musculoskeletal system include damage to the skeleton and soft tissues. Human joints are formed by bones with cartilage on their heads, ligaments, menisci. All these structures are surrounded by sacs filled with synovial fluid.

To understand their condition, patients ask the surgeon: what is bursitis of the knee joint, why does it have various clinical manifestations.

On a note!

Bursitis is an inflammation of the bags located in the knee area with an increase in the production of synovial fluid, the appearance of swelling and pain.

The disease occurs due to various reasons:

Symptoms

The most striking signs of inflammation occur during an acute process. The main symptoms of knee bursitis include:

1. Constant dull pain, aggravated by resting on a sore leg, bending at the knee.
2. The appearance of swelling in the joint area. The formation has a rounded shape, dense texture, painful on palpation.
3. There is swelling of the joint. The range of motion in the knee may be reduced.
4. The skin over the knee joint in the projection of the swelling turns red, its temperature rises.
5. Lymph nodes in the popliteal fossa increase, may be painful on palpation.
6. In some cases, the body temperature rises.

If you carefully consider the photo of knee bursitis, you can notice the above visual manifestations of the disease.

On a note!

Symptoms have different localization. The reason for this is the structural features of the knee joint. It includes 8 bursas with deep or superficial location. Some of them communicate with the capsule, while others look like closed cavities.

So in acute bursitis of the knee joint, inflammation often affects certain bags:

• non-joint prepatellar bursae: subcutaneous, subfascial, subtendinous;
• deep subpatellar bag (secondarily, as a result of arthritis).

Surgeons have described various localizations of bursitis.

Prepatellar bursitis

This is an inflammation of the prepatellar bursa. It occurs with loads, repeated injuries of the joint, prolonged kneeling.

Rarely develops. The clinical picture includes:

• the appearance of swelling;
• swelling of the anterior surface of the joint;
• moderate pain syndrome;
• local fever with reddening of the skin.

Infrapatellar bursitis

This inflammation looks like this: on both sides of the patella, a mobile soft-elastic formation appears, the symptoms are aggravated by pressure, leg extension. Mobility is slightly impaired.

Such bursitis often has a post-traumatic nature.

This inflammation of the joint bag is determined under the tendon of the quadriceps femoris and looks like a large rounded tumor up to 8-9 cm in size. The patient complains of pain in the area of ​​inflammation, unpleasant pulling sensations along the anterior surface of the thigh and decreased mobility in the knee joint.

On a note!

This type of bursitis may be accompanied by fever.

More often it is chronic and leads to deposits of calcium salts (calcareous bursitis).

Popliteal bursitis

The disease is associated with the popliteal bag. Patients turn to the surgeon with complaints of pain on the posterior-outer surface of the joint. Bursitis of the popliteal muscle must be differentiated from damage to the collateral ligament or external meniscus of the knee joint.

On the back surface of the joint, in the popliteal fossa, the so-called Baker's cyst occurs. It is a protrusion of a stretched bag filled with liquid. This disease occurs a second time against the background of synovitis with arthrosis, rheumatoid arthritis, after injuries.

A small cyst is practically invisible and does not cause significant inconvenience to the patient. There are no unpleasant sensations. When a significant volume is reached, it is determined under the knee, closer to the inner surface. To the touch, the cyst has a densely elastic consistency, shaped like an egg. In this case, patients may note:

• violation of flexion of the leg in the knee joint;
• the presence of a tumor under the knee.

On a note!

These signs occur independently, or against the background of the existing pathology of the joint. Symptoms become more pronounced after a long walk, climbing stairs.

Such chronic knee bursitis can go away without any treatment, when the symptoms disappear when the cyst is emptied into the joint cavity. Sometimes there are complications:

• breakthrough education with a clinic resembling deep vein thrombophlebitis;
• cyst infection.

The disease occurs infrequently, in persons of mature age. It occurs against the background of arthrosis of the knee joint, overweight.

Disturbs by painful sensations on the inside of the knee. They disturb at night with the pressure of one knee on the other. Palpation of this area is moderately painful, visually one can notice some swelling.

Since the symptom often occurs against the background of gonathrosis, patients report pain in the joint with an increase in the evening.

ICD 10 disease codes refer to M 70:

• M70.4 - prepatellar bursitis;
• M 70.5 - other bursitis of the knee joint;
• M 70.9 - soft tissue diseases due to overload, unspecified.

Development of the disease

If the disease arose as a result of an acute injury, tissue infection is possible, serous inflammation is replaced by purulent inflammation. In this case, the patient will complain of unbearable, “pulling” pains along the anterior surface of the joint, aggravated by palpation, local hyperthermia and redness.

On a note!

Usually acute bursitis lasts up to 2-3 weeks, then the symptoms of inflammation disappear. Recovery is coming.

Accession of the infection is dangerous by the development of purulent arthritis and the formation of phlegmon of the surrounding tissues. With a decrease in immunity and refusal of antibacterial treatment, septic complications are possible.

However, up to 50% of patients are at risk for developing chronic bursitis. Lack of timely treatment worsens the long-term prognosis. In this case, the disease will proceed with episodes of exacerbation and remission. With an exacerbation, the pain syndrome and other local signs are not so pronounced, they have a more “erased” character. Such bursitis is dangerous with gradual changes in the affected joint. There are scars, adhesions, impaired mobility.

With a single traumatic injury, bursitis of the knee joint is acute. Timely treatment leads to recovery, the prognosis for the patient in this case is favorable.

If knee bursitis occurs against the background of chronic injury, joint overload, the symptoms develop gradually with the formation of a protracted inflammatory process. The long course of the disease leads to a gradual deterioration of the condition, it will not be possible to cure it without any consequences.

Bursitis against the background of metabolic or autoimmune disorders develops as a chronic disease with periods of exacerbation and remission. In the absence of adequate treatment, the prognosis for the patient is unfavorable.

Diagnosis of bursitis

He deals with the issues of diagnosis and treatment of bursitis. Upon treatment, the patient will undergo a complete examination:

1. Interview with clarification of the time of onset of symptoms, connection with stress, injury or other conditions.
2. Inspection with palpation. The method will help to clarify the localization of pain, assess the change in the configuration of the knee joints, the presence of pain, hyperemia, fever.
3. Laboratory research methods are necessary for the differential diagnosis of bursitis and arthritis. The doctor will prescribe a general blood test, biochemical and immunological studies, a general urine test.
4. Instrumental diagnostics is aimed at detecting pathological changes, differential diagnosis with a tumor, hemangioma, arthritis.

Ultrasound or MRI can help determine the location of the joint lesion.

On a note!

X-ray examination is used only for the differential diagnosis of bursitis and arthritis.

With inflammation of the bags of the knee joint in the picture you can find:

• change in the size of the joint space due to exudate in the cavity of the bursa;
• deposition of calcium salts and osteoporosis in chronic bursitis;
• urate masses in place of articular surfaces with gout;
• fragments of bone tissue in the joint cavities in tuberculosis lesions.

What and how to treat

Allocate the main methods of treatment of inflammation of the bag:

• compliance with the protective regime;
• the use of medications;
• physiotherapy;
• traditional medicine;
• surgical treatment
• lifestyle change.

Mode for bursitis

To alleviate the condition of a patient with acute bursitis or at the stage of exacerbation of a chronic process, the following rules are recommended:

1. Ensuring rest of the knee joint. The patient needs bed rest, the limb should be kept elevated.
2. Joint unloading. Recommend the use of elastic bandages, canes.
3. Cold on the knee. This measure in the first few days from the onset of inflammation will help relieve pain and swelling.

On a note!

Patients often ask about the diet for bursitis. There is no special diet. However, you should pay attention to the diet and limit its calorie content in the presence of excess weight, monitor the sufficient intake of proteins, vitamins and vegetable fiber.

Medical treatment

Taking medications for inflammation in the joint is aimed at stopping pain and reducing inflammation. In acute bursitis, drugs are used in courses; chronic process requires supportive treatment for autoimmune or metabolic disorders. Surgeons prescribe the following groups of drugs:

1. Non-steroidal anti-inflammatory drugs in the form of tablets and (Nimesulide, Meloxicam, Aspirin, Ibuprofen). Local treatment of bursitis of the knee joint with NSAIDs is possible only while maintaining the integrity of the skin.
2. Hormonal preparations in the cavity of the bursa with severe inflammation (Hydrocortisone, Kenalog, Diprospan).
3. Broad-spectrum antibiotics in the development of an infectious process. Surgeons recommend treatment with drugs of a number of penicillins, cephalosporins.

Compresses with dimexide are recommended in the absence of wound surfaces. They are prescribed for both acute and chronic inflammation. To enhance the effect, mixing the main substance with novocaine and corticosteroid hormone is recommended. The duration of the procedure should not exceed 30-40 minutes, the course of treatment - up to 10 days.

exercise therapy and physiotherapy

Hardware treatment of bursitis is used in inpatient and outpatient settings. The scheme of procedures is selected by a specialist, taking into account possible contraindications to the procedure. The following methods have been proven effective:

• shock wave therapy;
• electrophoresis with drugs;
• UHF therapy;
• magnetotherapy.

On a note!

The use of physiotherapy exercises is recommended for patients after injuries and with chronic bursitis. Perform exercises through pain in an acute process should not be. Patients are advised to exercise on an exercise bike, swimming, active and passive flexion of the legs in the knee joints.

Treatment with folk remedies

To combat bursitis, methods of local and general exposure are used. Before starting treatment, the patient should consult with the surgeon.

Locally, for acute pain, ice, cabbage compresses, aloe are prescribed. To alleviate the residual symptoms of the disease, baths with needles, hay, hot lotions with herbs are used. The course of such treatment can take up to 1-2 weeks.

For oral administration, followers of traditional medicine recommend infusions and decoctions of herbs that have an anti-inflammatory, cleansing effect: clover, chamomile, St. John's wort, horsetail, linden.

Surgery

• bursa infection;
• ineffectiveness of conservative therapy;
• development of chronic bursitis.

Surgical treatment for purulent bursitis consists of puncture of the cavity, washing and administration of antibacterial agents. In case of severe inflammation, the surgeon will drain the knee bursitis: opening the bag and introducing a special drainage into it, through which the inflammatory exudate will drain.

In case of chronic inflammation and the ineffectiveness of conservative treatment methods, bursectomy of the knee joint is recommended. Before surgery, the doctor evaluates the patient's condition - the duration of the disease, the degree of mobility impairment, the severity of the pain syndrome, the number of intra-articular hormone injections performed.

The operation is performed in two ways: open and endoscopic.

In an open bursectomy, the surgeon opens the bursa, cuts it open, and sutures it. During endoscopic surgery, manipulations are carried out through punctures; this method speeds up the recovery of the patient. The effectiveness of the surgical method is high.

Within 4 years, I "grew" a tumor the size of a good egg under my knee. At first I did not notice the presence of this formation, then I hit my foot at a construction site and the next day I could not bend my knee. There was pain and some kind of round bump. Without attaching importance to this, I did not take any treatment and did not go to the doctor for another couple of weeks, until my frightened wife took me by the hand and took me to the surgeon.

I went through an examination and found a cyst. It hurt to bend my leg. The traumatologist warned that it would not go away on its own, only surgical treatment was needed. Having studied the reviews about the operation of other patients, he agreed to arthroscopic removal. It cost me a lot, but after 3 days I was already on my feet. Six months have passed since the treatment. There are no complaints.

Nikolai, Moscow

It is in these areas that neighboring tissues can be maximally displaced relative to each other. The bursa, like the articular cavity, is lined with a special synovial membrane - they often communicate with each other.

In total, there are about eight main bursae in the area of ​​the knee joint - four of them are closest to the articular cavity. These are infra-, supra- and prepatellar bags, located in the upper and lower parts of the knee, above the patella and the so-called "goose" bursa, located on the inner lower region of the knee.

What it is?

Bursitis of the knee joint is an inflammatory process that occurs in any of the prepatellar bursae - subtendonal, subcutaneous, or subfascial.

Reasons for development

Near the knee joint there are three bursae filled with fluid. Inflammation of the periarticular bag can provoke several main reasons:

1. Injuries - inflammation can be the result of ligament rupture, dislocation, fracture. Traumatic bursitis can also be caused by work associated with a constant load on the joint. In the risk category are builders, military, professional athletes. Post-traumatic bursitis is treated quite well.
2. Infection - the cause of the inflammatory process, most often become staphylococci. As a result of the progress of the disease, an increased accumulation of purulent discharge is observed. Purulent bursitis requires immediate treatment, as it can lead to amputation or general sepsis of the body and end in death.
3. Accompanying illnesses. Often, gout, arthritis, etc. can become a provoking factor. Often the pathology develops into a chronic, permanent form.

The symptomatology of the disease is pronounced and depends on the location and intensity of inflammation.

Classification

Maple bursitis, depending on the anatomical location, has the following classification:

Depending on the pathological changes, the disease can be of the following form:

• Acute, manifested by a sharp inflammation of the articular membranes, the painful process lasts up to a month.
• Subacute, pain is dulled and swelling decreases.
• Chronic, the symptoms increase gradually, the development of the pathological process occurs up to a year.
• Recurrent, appears under the influence of adverse factors for the patient's health.

The most dangerous complications of the disease can be the manifestation of osteomyelitis, followed by the formation of fistulas and blood sepsis.

Symptoms

Knee bursitis has the following symptoms (see photo):

1. Joints become inflamed and very painful. Especially when pressing on the affected area;
2. The diseased joint can hardly move;
3. Over the affected joint, the skin turns red and swells;
4. A swollen knee increases by 8 to 10 centimeters;
5. There is muscle weakness;
6. The person feels weak, cannot work normally;
7. Knee bursitis causes an increase in body temperature;
8. Bursitis of the knee joint makes itself felt usually at night.

If the above symptoms appear, it is important to consult a doctor for advice in order to start treatment of the disease in a timely manner.

What does knee bursitis look like: photo

The photo below shows how the disease manifests itself in humans.

Diagnostics

After examination, the specialist prescribes additional diagnostic procedures. In order to identify the cause of bursitis, it is recommended to undergo the following types of diagnostic examination:

1. X-ray examination.
2. Collection of anamnesis.
3. Ultrasound examination.
4. Thermal TV.
5. Lab tests.
6. Puncture of the knee joint to collect synovial fluid.
7. Magnetic resonance imaging.

Such an examination is necessary for the differential diagnosis of diseases of the knee joints with similar symptoms: synovitis, arthrosis, tendon rupture, osteomyelitis.

How to treat knee bursitis

Treatment of bursitis of the knee joint, as a rule, is carried out by conservative methods. In some cases, surgery is required. It is shown in the development of a purulent process, which is never treated with pharmacological drugs. They only aggravate the patient's condition in this case.

In the process of treating bursitis of the knee joint, it is necessary to adhere to general measures. These include:

1. Temporary restriction of active movements of the affected limb
2. If the inflammatory process is very pronounced, then the person is generally recommended to lie down until the disease subsides.
3. Use of crutches while walking, which spares the affected leg
4. Don't bandage your knee
5. Refuse to use thermal and cold procedures that adversely affect the condition of the tissues surrounding the knee joint.

Conservative treatment of knee bursitis involves therapy in the following areas:

1. The fight against the inflammatory process
2. Improvement of metabolic and nutritional processes in periarticular tissues
3. Carrying out rehabilitation therapy after dealing with an acute process. This will restore the lost function of the knee joint.

Anti-inflammatory treatment includes both the use of topical agents and general action. Local therapy, which helps to reduce the severity of the inflammatory reaction, involves the appointment of ointments and Dimexide solution. The latter improves the penetration of active ingredients into tissues, so the therapeutic efficacy increases. The most commonly used ointments for knee bursitis are:

1. Fastum-gel
2. Diclofenac gel
3. Dolgit and others.

They must be applied to the affected area twice a day - in the morning and in the evening. Rub until completely dry, while massage movements are not recommended. After rubbing, a gauze compress with Dimexide is applied for several hours.

Non-steroidal anti-inflammatory drugs are used as a general anti-inflammatory method. However, they have certain contraindications that limit the use of these funds, namely:

1. Ulcerative lesion of the gastrointestinal tract
2. Individual intolerance to the drug
3. allergic reactions
4. Aspirin bronchial asthma.

Trophic therapy is indicated after a decrease in the severity of signs of inflammation, first of all, a decrease in pain and swelling. Within this direction are shown:

1. Therapy with magnetic fluxes
2. Use of laser energy
3. Electrophoresis with an aqueous solution of Dimexide
4. Ozokeritotherapy
5. Paraffin therapy
6. Use of nicotinic acid, B-complex and antioxidant vitamins
7. The use of biostimulating agents, which include aloe, fibs, solcoseryl.

Rehabilitation therapy for knee bursitis includes:

1. Therapeutic exercise
2. Massage
3. Balneotherapy.

Local anti-inflammatory therapy is also carried out with the help of injections of corticosteroid drugs. This manipulation should be performed only by a trained doctor. If the patient has no contraindications, topical corticosteroids should not be delayed. Tolerability of these drugs with this method of use is good, and side effects are practically absent. Corticosteroid drugs can achieve the following effects:

1. Rapid relief of the inflammatory process
2. Prevention of chronic bursitis
3. Rapid restoration of normal functioning of the knee joint.

Corticosteroid drugs are divided into two classes:

1. Fast-acting drugs, such as Celeston, Hydrocortisone
2. Long-acting, for example, Diprospan.

To reduce the severity of pain in one syringe, the doctor collects not only a corticosteroid, but also a local anesthetic. This greatly improves the tolerability of the procedure. The duration of this treatment is determined individually and can vary from 5 to 10 procedures.

Surgical intervention

Bursitis of the knee joint, the treatment of which had no effect, may require surgical intervention in the form of aspiration (suction) of the contents of the joint capsule and the introduction of corticosteroids into it.

This procedure is performed using a thin needle under local anesthesia. After draining the joint capsule, the doctor may inject hormonal drugs - corticosteroids - into it. This is necessary in order to stop the inflammatory process. Then it is necessary to continue wearing the elastic bandage and ensure prolonged rest of the limb (usually 48 hours). This treatment is much more effective than drug treatment (non-steroidal anti-inflammatory drugs), since the tablet forms have a general effect on the body, often without penetrating into the joints.

In rare cases, treatment is ineffective, and the only way out is the surgical removal of the prepatellar joint capsule. The restoration of normal joint functions after such an operation occurs within a few days, and a return to a full life without limitation of physical activity can be carried out in 2-3 weeks.

Folk remedies

You can reduce the unpleasant symptoms of knee bursitis using folk methods:

• Salt compress. For half a liter of boiling water, you need to take a tablespoon of salt. The solution draws fluid from under the skin. Soak a coarse woolen cloth in the solution, unscrew it and apply it to the swollen knee. We wrap a film and a warm scarf or scarf over the hot compress. The procedure lasts 3 - 8 hours. It is carried out once a day until the swelling disappears completely. Usually one week is enough to completely get rid of the disease.
• Ordinary sugar is used as follows - the sand is heated in a clean, dry frying pan, preventing it from dissolving. After the sugar warms up well, it is transferred to a linen bag and applied to the sore knee. For longer preservation of heat, the bag is covered from above with a film, a warm woolen scarf or a scarf. In the morning, the compress is removed, the wet sugar is thrown away, the next procedure is carried out with a new batch of granulated sugar. The course of treatment lasts until complete recovery.
• Vegetable compresses. Potatoes, beets or cabbage are cut into circles and spread on a clean cloth, which is applied to the affected joint. A plastic bag and a warm cloth are wound on top. Remove the compress in the morning. Important point! The listed vegetables are recommended to be alternated until the bursitis is completely cured.
• Lotion with propolis. Pour 10 grams of propolis with vodka (150 milliliters) and let it brew for 5 days. After a while, apply lotions to the swelling until they completely resolve.
• Burdock root decoction. 15 grams of the plant should be boiled for 5 minutes. Let it brew and do compresses for a couple of hours for 20 days.
• To strengthen the body and increase its resistance to inflammation, a celery drink is prepared. They take a large spoonful of plant seeds, pour them with 250 ml of water brought to a boil and insist tea for 2 hours. Then the drink is filtered, it should be drunk in the morning and evening hours. The duration of treatment is 14 days.
• Place flax seeds in a chintz bag and apply to damaged joints. The duration of treatment is two weeks.
• Break off a cabbage leaf and apply to the affected joint. Insulate. Compress to do within 7 days.

Before starting treatment with folk remedies, it is important to consult a doctor. The doctor, having assessed all the symptoms and the patient's condition, will tell you what non-traditional methods will help defeat the disease in your particular case.

Purulent and neglected pathology is treated only under the supervision of a doctor!

Recovery

The speed of restoration of knee mobility is largely related to the efforts of the patient himself. To shorten the rehabilitation period, it is necessary to perform physical exercises, play sports.

It is necessary to abandon activities that lead to the formation of microtraumas of the joint. At this stage, folk remedies are effective: infusions and compresses that reduce swelling.

To date, there is no worthy alternative to traditional methods of treatment. Folk methods can only be used as an aid to the rapid recovery of the patient.

Prevention

Preventive measures include:

• elimination of all inflammatory processes in the body;
• gradual strengthening of the ligamentous apparatus of the lower extremities;
• refusal to jerk during sports, heavy physical exertion;
• weight control;
• with increased injury risk - protection of the knee joint area with special devices;
• if possible, avoid low temperatures in the specified zone;
• if it is necessary to be in the “kneeling” position, do warm-ups hourly.

Bursitis of the knee

The knee joint is one of the most complex joints in the human body, equipped with auxiliary elements that ensure the movement of the limb in certain directions and maintain its anatomical structure under heavy loads.

The bursa is considered an important structural formation of the knee. It is a periarticular sac filled with synovial fluid. Thanks to it, the friction of the cartilages against each other does not lead to their rapid wear, and the excessive mechanical pressure of the articular bones on each other does not result in their injury.

Inflammation in the bursa, inevitably leads to the accumulation of exudate inside the knee - synovial fluid mixed with blood and pathogenic microflora. This process is known in medical practice as knee bursitis.

Classification

In the cavity of the knee there are several articular bags (burs).

1. When the patellar articular bursa is affected, the diagnosis is made suprapatellar bursitis of the knee (second name - prepatellar). This type of disease is more common than others, and the causes of its occurrence are prolonged mechanical pressure on the knees and their injury.
2. When the popliteal synovial bursa is affected, it is diagnosed infapatellar bursitis. An injury to the knee ligaments can provoke inflammation of this type.
3. When inflammation occurs in the synovial sac located inside the knee joint closer to its back, goose foot bursitis is diagnosed. The cause of its occurrence is the excessive pressure of the bones on each other with excess weight in the patient.

In addition to the localization of inflammation, the classification of bursitis includes such parameters as the sources of the pathological process in intraarticular bags, and divided into several groups:

1. Germ-free (serous) knee bursitis- one of the most easily cured forms of the disease.
2. Infectious or purulent bursitis of the knee- a dangerous form of the disease, requiring great efforts to completely eliminate it.
3. Post-traumatic knee bursitis- develops against the background of numerous injuries of ligaments and intra-articular bags. Most often, this form is associated with an infectious lesion of the bursa by gonococci, staphylococci and other microorganisms.
4. Calcification or calcareous bursitis, in which there is an accumulation of lime inside the articular bags. Most often, this pathology is provoked by a long-term chronic process of inflammation.

Also in clinical traumatology, the forms of bursitis are distinguished according to the nature of the course. According to this classification, the disease can acquire acute or chronic course. Each factor mentioned to a certain extent affects the course of the disease, the set and severity of symptomatic manifestations, as well as the duration of treatment.

Suprapatellary bursitis: symptoms and treatment

Suprapatellar bursa- the largest synovial bag in the knee joint. It is located on its front surface from above, and its main function is to protect the knee from external traumatic influences.

In anatomy, it has a second name - prepatellar. Inflammation of this part of the joint or prepatellar bursitis occurs more often in athletes and people whose activities involve frequent flexion and extension of the legs.

The course of the disease can be acute and chronic . In the first case

the symptomatic picture is pronounced, while chronic bursitis of this type can have blurred symptoms and cause inconvenience when moving for a long time.

Symptoms and treatment of suprapatellar bursitis of the knee , have a close relationship, they can be diagnosed by external examination. An X-ray of the knee is also used for this. At the same time, the area of ​​the lesion of the synovial bag and the accumulation of fluid in it are clearly distinguished on the pictures.

How to treat suprapatellar bursitis? This is decided by a specialist traumatologist. Most often, therapy includes taking medications, surgery, as well as a physiotherapeutic effect on the articular tissues in order to free the bursa from accumulated exudate.

With uncomplicated purulent infections of suprapatellar type bursitis, treatment consists in eliminating painful symptoms with external means: ointments with painkillers And anti-inflammatory effect (DeepRelief, Nise gel, chloroform liniment, etc.). Patients are also shown oral NSAIDs (Diclofenac, Indomethacin and Ketoprofen).

Antibiotics for bursitis of the suprapatellar bursa are prescribed in case of infection with subsequent suppuration. In most cases, the problem can be eliminated with the help of drugs with a wide spectrum of action.

Surgery for chronic prepatellar bursitis of the knee , considered the most effective way to treat the disease. Surgical intervention involves opening the bursa by puncture to free it from fluid, followed by the introduction of drugs with an antimicrobial or anesthetic into the synovial cavity.

For the entire period of treatment of bursitis, it is recommended to limit movements in the knee joint with the help of special splints or the method of tight bandaging. Also, the patient should reduce the load on the limb, moving with the help of a cane or crutch (depending on the severity of the disease).

Symptoms and treatment of infrapatellar knee bursitis

Infrapatellar bursitis

The disease known as "jumper's knee" or deep infrapatellar bursitis, this is an inflammation in the bursa, which is located under the kneecap and softens the blows when jumping.

Cause of this type of bursitis- a sharp increase in pressure on the bursa, which occurs at the moment a person lands on the surface. Most often, skydivers and athletes suffer from this form of the disease.

Symptomatic manifestations of the disease consist in soreness of the knee joint and a feeling of its fullness. Swelling and redness in case of injury to the infrapatellar synovial sac are almost invisible from the outside. It is almost impossible to diagnose such a pathology by palpation and external examination with 100% certainty. To complete the picture, if this form of bursitis is suspected, it is customary to do it.

In clinical practice, cases of infectious infrapatellar bursitis are practically unknown. This is due to the fact that trauma to the bursa occurs as a result of the appearance of hemorrhages on its inner surface, which provoke the onset of inflammation. That is why antibiotics and surgical intervention are not used in the treatment of this pathology.

To reduce the inflammatory process with this type of disease, it is enough to immobilize, as well as regularly use anti-inflammatory drugs.

With increased pain and the inability to move normally, patients are prescribed painkillers and NSAIDs. The positive effect is also treatment with folk remedies:

• compresses;
• lotions;
• herbal poultices.

Bursitis of the goose foot

Goose or anserine bursitis of the knee joint- inflammation of the bag located at the back of the knee. Most often, this pathology is the result of excessive wear of the articular elements due to pressure on them.

This form of bursitis is diagnosed mainly in women suffering from obesity and / or osteoarthritis. Symptomatic manifestations of the disease are expressed in acute pain in the knee when climbing stairs or descending from it. When walking on a flat or sloping surface, they do not cause discomfort.

With a disease of goose foot bursitis, treatment includes the use of external agents with anti-inflammatory and analgesic effects. Folk remedies in the form of compresses and rubbing can also help in getting rid of pain.

In case anserine chronic bursitis occurs, treatment consists in surgical excision of the synovial sac.

Signs and symptoms of serous, purulent and calcareous bursitis

In trauma practice, in addition to the localization of inflammation, it is important to take into account and type of inflammatory reaction in the bursa. Purulent, serous and calcareous bursitis proceed in completely different ways, and specific drugs and therapies are used to treat them.

With serous bursitis of the knee joint (synovitis), which is considered the safest in terms of consequences, the symptoms most often consist of soreness and swelling. Despite the accumulation of synovial fluid in the bursa, there is no possibility of damage to adjacent tissues. In this case, the treatment synovitis - bursitis of the knee joint involves taking drugs that eliminate the symptoms of the disease, as well as anti-inflammatory drugs.

With an infectious origin of inflammation of the bursa the symptomatic picture is supplemented by a deterioration in the general condition of the patient and an increase in body temperature. If a patient is diagnosed with purulent bursitis, treatment must necessarily include taking antibiotics and washing the cavity of the bursa with antimicrobial solutions.

The danger of this type of inflammation consists in a high probability of bursa rupture and subsequent infection of intra-articular structures. Often, with a similar outcome, the patient is diagnosed with purulent arthrosis of the knee joints.

Lime (calcinous) form of bursitis develops due to chronic inflammation of the synovial knee bag. As a result of a long-term disturbance of metabolic processes in its internal cavity, the liquid changes its chemical composition, being enriched with calcium. Its deposits inside the bursa lead to noticeable discomfort when walking. Treatment for calcareous bursitis of the knee joint is to eliminate the causes of inflammation. Based on this, medicines are selected.

When a large amount of calcium is formed in the bursa, a surgical operation is performed to remove calculus formations through small incisions.

Despite the variety of types, types and forms of the process, it depends on the timely appeal to a traumatologist or surgeon. In most cases, severe forms of the disease occur due to untreated mild inflammation and trauma.

In every major joint of the human body there is a periarticular bag - a bursa filled with fluid, the main purpose of which is to reduce friction and stress on the tissues of the joint.

Bursitis is an inflammatory process of the cavity that occurs due to injury or infection. There are three periarticular bags in the knee.

The attending physician, when deciding how to treat knee bursitis, will determine the location and severity of the inflammation. According to the results of the study, the disease is assigned an ICD code.

Bursitis of the knee joint - what is it, causes and symptoms

The symptomatology of the disease is pronounced and depends on the location and intensity of inflammation. It is customary to distinguish the following symptoms of bursitis:

• Pain.
• Changing the shape of the knee.
• Edema.
• Change in color and temperature of soft tissues.
• Mobility restrictions.

The consequences of bursitis of the knee joint can be a permanent limitation of mobility, sepsis. At an advanced stage, surgery will be required to remove the joint bag.

Varieties of knee bursitis

1. Goose bursitis.
2. Prepatellar.
3. Infrapatellar.

• Ossifying bursitis - characterized by the presence of seals in the knee area. As a result of the disease in this form, the patient has significant limitations in mobility.
• Anserine bursitis - most often develops in women who are overweight. The internal cavity of the joint, called the "crow's foot", becomes inflamed at the junction of the semitendinous, tailor and graceful muscle tissue.
• Acute bursitis is characterized by intense pain localized at the site of inflammation of one of the bursae. The inflammation proceeds quickly. A large amount of serous exudate is released.
• Chronic bursitis - occurs in people whose professional activities are associated with permanent injuries or stress on the knee. The synovial bag grows slowly, exudate collects in it, the bursa membrane changes. Growths and cysts appear.

What is dangerous bursitis in the knee

Another unpleasant consequence of the inflammatory process is the removal of knee bursitis. This measure is resorted to only in extreme cases, as it leads to a permanent limitation of joint mobility.

The consequences of knee bursitis depend on the location of the inflammatory process, the nature of the manifestation and the causes that provoked the onset of the disease. So infrapatellar bursitis of the knee joint, in general, responds well to drug therapy, and infectious is often associated with the need for long-term antibiotics.

How to treat bursitis in the knee (traditional methods)

Drugs for treatment are prescribed exclusively by the attending physician, according to the results of a diagnostic study of exudate sampling. The intensity of drug intake is selected based on the general condition of the patient. To reduce pain, relieve inflammation and treat the knee joint with bursitis, ointments are prescribed.

With limited mobility with bursitis of the knee joint, a set of exercise therapy exercises is prescribed. Classes are developed individually and contribute to the restoration of the basic functions of the knee.

The patient is additionally assigned a visit to physiotherapy. As you recover, it is recommended to gradually increase the load, play sports, visit the pool.

Self-medication for treatment is strictly contraindicated. In case of recurrence of the disease, before prescribing therapy, it is necessary to retake all the necessary tests.

Alternative methods for knee bursitis

You can remove puffiness with a compress of burdock leaves. A decoction of the crushed roots of the plant helps. A spoonful of the crushed mixture is poured into 0.5 liters. water. Boil for 5 minutes. Apply a compress for 2 hours.

You can reduce the unpleasant symptoms of suprapatellar bursitis of the knee joint with the help of propolis tincture on vodka. The mixture is prepared in a ratio of 1 to 10. Infuse for 5 days.

Treatment of knee bursitis at home does not eliminate the need to consult an orthopedist. Some types of inflammation can only be removed with the help of drug therapy.

Restoration of the knee joint after bursitis

It is necessary to abandon activities that lead to the formation of microtraumas of the joint. At this stage, folk remedies are effective: infusions and compresses that reduce swelling.

To date, there is no worthy alternative to traditional methods of treatment. Folk methods can only be used as an aid to the rapid recovery of the patient.