Bursae are fluid-filled sacs that help facilitate movement of your joint.
There are about 11 bursae on each side around the knee joint.
When these bursas become inflamed due to high activities and other problems and cause disturbance in the movement of the knee joint, the term knee bursitis is used.
In the following, we will introduce you to the most common symptoms of knee bursitis, the causes of knee bursitis, as well as the definitive and basic diagnosis and treatment of knee bursitis.
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What are bursae and what is meant by bursitis?
Each of our knees has eleven bursae. Bursae are small cushion-like sacs that contain fluid. These fluids are secreted from the cells of the inner wall of these small sacs, and the task of these sacs is to act like a cushion and reduce the friction between the bones and tendons around the knee joint.
We have 11 bursae in each of our knees that facilitate the movements of our knee joint.
When the inner cells of the wall of these sacs become inflamed, the term bursitis and knee inflammation is used.
In few cases, the bursae located on the patella of the knee may become infected, that is, we have infectious bursitis or septic bursitis of the knee, which in addition to pain and swelling of the knee, fever and chills are added to your symptoms.
Inflammatory bursitis of the knee occurs when (as the most common reason), due to excessive use of the joint and bending the joint, the cells of the inner wall become inflamed.
In this way, following this inflammation, cells secrete more synovial fluid, and with the increase of fluid, your pain and sensitivity increases.
In general, it is said that the higher the level of inflammation, the higher the increase of this fluid, and as a result, the swelling and sensitivity and pain in the knee will increase.
One of the most debilitating conditions that can happen in knee bursitis is that the bursa becomes infected.
Infectious bursitis or septic bursitis is when the fluid inside the bursa is infected. In these cases, bleeding occurs inside the bursa space.
In septic bursitis of the knee, the level of irritability and the level of sensitivity to touch, pain and swelling and the reduction of the range of motion of the knee are increased.
Symptoms of knee bursitis
The most common symptoms of bursae inflammation in our knees, which are called knee bursitis, are:
- Pain and swelling in the area of inflammation and injury
- Pain in the lesion area, especially when resting
- The third symptom is the obvious decrease in the range of motion of the knee joint, so that we cannot bend and straighten our joint as before
- The next symptom is that even passive movements cause pain
- And the next item is sensitivity of the knee when touched
- If infection is the cause of inflammation of the knee bursae, i.e. there is an septic bursitis, fever and chills and increased sensitivity to touch and warmth and redness of the skin on the knee surface are also common
Bursae around the knee
The bursae that usually get inflamed around the knee include:
The bursa that is located below the patella
A bursa located on the patella of the knee
A bursa that is located between the muscle tendon and the tibia
And a bursa called Pes Anserine.
Causes of knee bursitis
It is said that the main and most important factors that cause inflammation of the knee bursa and cause knee bursitis is a direct blow to the knee or excessive use of the knee joint.
Another important issue is that jobs such as gardeners and people who work in mines are more at risk of developing knee bursitis.
Most of the reasons that increase the risk of bursitis around the knee are:
- Autoimmune diseases such as rheumatoid arthritis and rheumatism
- Constant falls
- Metabolic diseases such as gout
- knee arthritis
- Putting pressure on the knee joint
- Damage to knee tendons
Types of knee bursitis
- Peripatellar bursitis:
This bursa is located in front of the knee and is exactly below the patella and it mostly happens in people who work on their knees for a long time, for example, people whose job is to install carpets or people who put their knees on the floor while washing the floor.
- Pes Anserine bursitis:
This type of inflammation occurs in the inner part of the knee and usually happens due to overuse of the knee.
- semimembranosus bursitis:
It is a common type for bursitis that forms behind the knee and is a complication that most people with arthritis face. This bursitis is located between the tendon of the hamstring muscles and the gastrocnemius muscle of the back of the leg and causes sensitive irritation of the swollen area and pain behind the knee.
- Two other types of knee bursitis are: infrapatellar bursitis, which occurs below the patella, and iliotibial bursitis.
- Septic bursitis knee
septic bursitis of the knee occurs when an infection causes inflammation of the bursa sac. In most cases, these infectious bursitis occur in bursae that are located on the surface of the skin.
For example, the patella bursa in the knee area and the olecranon bursa in the elbow.
septic bursitis occurs mostly in men, and the average age of affected men is usually 50 years.
In most cases, it is caused by occupational injuries, for example, in carpenters, athletes, or pipe openers.
It is also more common in people who have concomitant diseases such as uncontrolled diabetes, arthritis or diseases such as gout and rheumatoid arthritis.
People who take immunosuppressive drugs are also very susceptible to septic bursitis.
Unlike non-infectious bursitis, which is not considered a serious and emergency medical condition, septic bursitis is a potentially serious and dangerous medical condition.
- MCL bursitis
Knee bursitis is a condition that causes pain and discomfort in the inner part of the knee in line with your leg.
Pes Anserine Bursitis is an inflammation of the bursa that is located right between the leg bone (tibia) and the hamstring muscle tendon inside our knee, when there is a lot of movement in this area, in other words, when we use the joint too much, the bursa is irritated.
The cells of the inner wall of the bursa are stimulated and produce a lot of fluid, which causes swelling and pressure in the adjacent parts.
The pain and tenderness in these cases is right on the inside of the knee and approximately 2 to 3 inches below the joint.
Young athletes such as runners, swimmers, especially people who do breaststroke and backstroke are more prone to this knee bursitis.
Middle-aged women with excess weight and people who are 50 to 80 years old and have knee arthritis are also more likely to suffer from bursitis.
Pes Anserine Bursitis or knee tendon bursitis affects up to 75% of people with knee arthritis.
It is also said that one of the companions of this disorder is type 2 diabetes.
It means that about 25 to 35% of type 2 diabetic patients who have knee pain are suffering from this type of bursitis.
In the other word type 2 diabetes is a risk factor for this type of bursitis.
Physiotherapy can be a safe and effective way to reduce pain and swelling, and knee weakness to relieve the symptoms of this bursitis.
It is said that Pes Anserine Bursae is a sac filled with fluid, which is located right near the medial collateral ligament or mcl, and when the movements of flexion and adduction of the knee are high, this bursa becomes inflamed.
- Bursitis after knee replacement surgery:
It is said that about 20% of all people who undergo Total Knee Arthroplasty experience knee pain.
Knee pain has various causes. One of these symptoms can be inflammation of the bursa between the tibia and the tendon of the hamstring muscles.
Inflammation of this bursa is very common after Total Knee Arthroplasty surgery.
It is said that most of these patients get rid of this painful pain by following their physiotherapy carefully.
- Right knee bursitis:
Repetitive movements and applying excessive pressure when opening and closing the right knee joint can cause inflammation of the cells of the inner wall of the small bursa sacs of your right knee.
These sacs are actually cushions that make the movements and wear between the tendons and bones easier in your right knee joint.
Although the most common cause of bursitis or inflammation of the left knee bursa is repetitive movements and putting too much pressure on the knee, arthritis and diabetes, especially type 2 diabetes, are problems and injuries that increase the likelihood of this inflammation.
Diagnosis of knee bursitis
It can be said that the doctor’s knowledge and skill to take a detailed history of a person with knee pain can be the main pillar of diagnosis.
After the history, a detailed physical examination and the use of imaging methods can help to diagnose knee bursitis and determine the location and the change in the severity of the injury.
In cases where there is an infectious bursitis, the person may be forced to experience more diagnostic and therapeutic conditions in the clinic, such as Joint aspiration (also called arthrocentesis) and sending the sample to the laboratory for culture and analysis.
In the acute phase of knee bursitis, it is necessary to rest and limit the activities that cause the onset and exacerbation of knee pain.
- Reducing mobility for a long time is not recommended
- Elevation and cold compress
- Keeping the lower limbs above the level of the heart can also help
- Common pain relievers that are also anti-inflammatory and are available in pharmacies without a prescription, such as ibuprofen and naproxen for a limited time
- In the long term, performing stretching exercises and strengthening the knee support muscles
- Exercise therapy and using magnet therapy
- Laser therapy performed by physiotherapists can also be performed
Although knee bursitis causes a lot of pain and discomfort and limits your knee activity, it is not considered a serious medical problem and does not make you suffer from dangerous complications.
The matter becomes more serious and urgent when the bursitis is infectious and you experience septic bursitis. septic bursitis can be dangerous, serious and even life-threatening.
So, with the addition of fever, chills, heat and swelling on the knee, be sure to visit a reputable center as an emergency.
Bursae are small fluid-filled sacs that are placed between tendons and joint components and facilitate the movements of bones and tendons relative to each other.
Excessive movements and excessive use of the joint or direct blow and pressure on the joint cause the wall of this bursa to become inflamed and increase the amount of fluid secretion inside this sac.
Bursitis is often non-infectious and is called non-infectious bursitis of the knee, which is associated with pain, swelling and limitation of movement.
Emergency cases in which fever and chills are added to the symptoms should be treated quickly under the title of septic bursitis of the knee.