From the Research
The natural course of prepatellar bursitis typically involves spontaneous resolution over weeks to months if the causative factors are eliminated, with most cases resolving with rest, activity modification, and avoidance of kneeling. Initially, the condition presents with swelling, warmth, and pain over the anterior knee, which may gradually improve with conservative management. Conservative treatment includes NSAID medications like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks to reduce inflammation and pain, as supported by a systematic review and meta-analysis published in 2021 1. Ice application for 15-20 minutes several times daily and compression with an elastic bandage can help reduce swelling. If the condition is caused by repetitive trauma, such as frequent kneeling, eliminating this activity is crucial for healing. In cases of infection (septic bursitis), antibiotic treatment is necessary, and the condition may take longer to resolve. Without treatment, chronic prepatellar bursitis can develop, characterized by persistent swelling, thickening of the bursal wall, and recurrent episodes of acute inflammation.
Some key points to consider in the management of prepatellar bursitis include:
- Avoiding activities that aggravate the condition, such as kneeling
- Using NSAID medications, like ibuprofen or naproxen, to reduce inflammation and pain
- Applying ice and compression to reduce swelling
- Considering alternative treatments, such as sclerotherapy, in cases of recurrent or chronic prepatellar bursitis, as reported in a case study published in 2018 2
- The importance of proper diagnosis and treatment of septic bursitis to prevent long-term complications.
It is essential to note that while topical NSAIDs have been shown to be effective in reducing pain and improving physical function in patients with knee osteoarthritis 1, the natural course of prepatellar bursitis is distinct and requires a tailored approach to management. A thorough evaluation of the patient's condition and medical history is necessary to determine the best course of treatment, taking into account the potential benefits and risks of different treatment options.