All joints of the human body are enclosed in a synovial bag, otherwise it is called bursa. It is designed to protect the joint from all types of damage, but pathological processes may occur in a joint bag due to a number of factors. Inflammation of the synovial membrane of the knee is bursitis. The bag itself is a small hollow formation filled with exudate, designed to lubricate the joint, providing a painless, smooth movement.
Causes of occurrence
Bursitis of the knee joint (according to ICD-10 code M70-M71) most often appears for such reasons:
- Excessive load on the lower limbs (at-risk professional athletes).
- Frequent and constantly recurring microtrauma (the problem is encountered by the nature of professional activity).
- Significant single damage, knee injury.
- A number of chronic diseases - scleroderma, gout, etc. In this case, bursitis of the knee joint is a consequence of a more global pathology.
- Infection of the articular bag through wounds, microcracks by pathogenic microflora. Also, if the body has chronic foci of inflammation (suppuration of wounds, sepsis, boils, etc.), then with the bloodstream or lymph flow, the infection reaches the synovial bag.
A number of factors increase the risk of developing the disease:
- Taking steroid drugs.
- Allergic reactions.
- Metabolic disorders.
- Pathology of the kidneys, intoxication.
- Autoimmune pathologies.
Experts note that in some cases it is impossible to determine the reason why knee bursitis occurred.
Classification
Safety and functionality of the knee provide three synovial bags. Types of inflammation are classified depending on which of them has been affected:
- Suprapatellar bursitis of the knee or popliteal bursitis. The most likely cause of the pathology is a previous injury to the hamstrings. Most often, this form of inflammation is diagnosed in athletes, the reason for this is excessive physical exertion, trauma, tearing of tissues, ligaments.
- Prepatellar bursitis of the knee joint is the most common form of the disease. Due to a kneecap injury, the patella is affected.
- Baker cysts. Pathology mainly occurs in people with overweight, inflammation covers the lower inner part of the knee.
Bursitis of the knee joint occurs in two forms - acute and chronic. Depending on what kind of exudate will accumulate in the joint bag, another classification is made:
- Purulent inflammation (bacterial inflammation).
- Serous bursitis (aseptic inflammation).
Pathology stages
Bursitis of the knee joint proceeds in several stages, which have their own time frame and symptoms:
- Acute - inflammation is rapidly progressing, there is hyperthermia, swelling of the tissues, the patient experiences acute pain, chills.
- Subacute - the pain becomes dull and permanent, edema of the affected area disappears, the general condition of the patient improves.
- Chronic - the membranes of the articular bag are compacted, fibrous tissue appears, the patient feels limited in movement. Lack of therapy can lead to the appearance of several cavities in the bursa, where necrotic areas will subsequently form.
- Recurrent - periods of exacerbations are replaced by remissions.
Symptoms
Knee pain may be the first indication of bursitis of the knee joint. Symptoms of each type of disease give a different clinical picture, the exact localization of the lesion is common in it. With inflammation of the patella, the patient feels pain in the anterior surface of the knee, difficulty walking.
With external examination, a swelling of the patella is observed, with pressure and palpation, a soft and elastic formation is felt. The surrounding tissue is slightly swollen, a slight local increase in temperature may appear. The motor functions of the joint are most often fully preserved, only in some cases a slight restriction of movements may occur.
Suprapatellar bursitis of the knee joint is an insidious disease. Its frequent complication is infection of the periarticular bursa, in which case the following symptoms are observed:
- A soft, elastic tumor forms in the patella region of the lower limb. As education progresses, infection can occur.
- On palpation, the patient experiences acute pain.
- The tumor is rapidly progressing and can reach up to 100 mm in diameter.
- As a result of the pain syndrome, flexion and extension of the knee is given to the patient with great difficulties, while the joint itself is not damaged.
- Signs of intoxication can be observed - an increase in body temperature, general malaise, profuse sweat, etc.
- If untreated, the disease becomes chronic and the patient’s movement is possible only with the help of an additional support (cane). In the joint cavity, calcium salts begin to settle.
Aseptic bursitis of the knee joint has mild symptoms. Patients notice discomfort and pain only after prolonged standing or long walking. The appearance of the knee is little susceptible to changes - there is a slight swelling. With flexion and extension of the leg in the knee, the patient experiences pain. The accumulation of exudate causes the formation of an elastic formation in the popliteal fossa. Suppuration of accumulated fluid causes purulent bursitis, its main manifestations are as follows:
- Sharp pain, twitching sensation.
- Swelling of tissues, tumor formation.
- Redness, local increase in temperature in the affected area.
- Enlarged lymph nodes, limited mobility.
- Signs of body poisoning.
Chronic bursitis of the knee joint can occur for several reasons:
- Lack of therapy in the acute form of pathology.
- The failure of the disease.
- The constant occurrence of microtrauma.
Chronic inflammation of the periarticular bag is characterized by a sluggish process with periodic exacerbations, the formation of cysts is a frequent manifestation of the pathology.
Treatment of patella inflammation
One of the common types of pathology is suprapatellar bursitis of the knee joint. Treatment is carried out after diagnosis, which includes:
- Ultrasound and X-ray of the inflamed joint.
- Laboratory research.
- Puncture test of accumulated exudate. When pus is detected, purulent inflammation is detected, in its absence - aseptic.
Therapies are prescribed depending on the course of the disease - conservative or surgical. At the initial stage of the disease, it is recommended to apply a cold compress and rest the limbs. In a chronic course, pressure dressings, rest and limb position on a raised platform are necessary, this position will help prevent swelling.
Also, in chronic suprapatellar bursitis of the knee, removal of fluid from the joint with punctures is indicated, followed by washing the cavity with antibiotics or corticosteroids. Within a few days after the procedure, the pain syndrome will decrease.
Surgical operations are prescribed for advanced chronic inflammation complicated by an infectious lesion, in cases where drug treatment was powerless. Interventions are performed under local anesthesia. During the operation, a periarticular bag is opened, partial removal of the bursa tissue and cleansing of the cavities is performed. In severe cases, the upper wall of the joint cavity is completely removed.
Conservative treatment
The treatment of joint diseases is the responsibility of orthopedists and traumatologists. To eliminate the inflammatory process with bursitis of the knee joint, the following conservative treatment methods are used:
- Cold compresses.
- Physiotherapy procedures.
- Drug treatment.
In this type of lesion, physical activity of any form, including physiotherapy exercises, is prohibited.
Recommended compresses:
- Icy - place ice in a plastic bag, wrap it with a cloth and apply to the affected joint for 3-4 minutes with a break of 5 minutes. The number of repetitions is up to 10 applications.
- Cold - soak a soft towel with cold water and cover it with a knee for several minutes. The compress is removed, the fabric is again wetted with water and applied. The duration of the entire procedure is up to 25 minutes.
- Vodka - put a cloth soaked in vodka on the inflamed knee, hold for about 30 minutes. This type of compress is recommended for use at elevated temperatures.
In the case of intolerable pain in the knee, the doctor may prescribe a local injection of pain medication directly into the area of inflammation. Blockade is achieved by the use of novocaine, glucocorticoid groups of drugs.
Drug treatment
Long-term therapy requires bursitis of the knee joint. Treatment with drugs pursues such goals - the removal of inflammation, the elimination of pain.
Effective remedies:
- Nonsteroidal anti-inflammatory, anesthetizing tablets - Piroxicam, Diclofenac, Remethan, Ibuprofen, etc. The course of administration is designed for 3 or 4 weeks. The results will become noticeable 14 days after the start of treatment.
- Anti-inflammatory corticosteroid preparations in tablet form - Metipred, Blefamide, Prednisolone, etc.
- Anti-inflammatory corticosteroid preparations for external use (ointments) - Hydrocortisone, Lokoid, etc.
- Non-steroidal ointments - “Diclofenac”, “Diclac-gel”, “Ortofen”, etc.
- For bursitis of the knee joint (according to ICD-10 code M70-M71), weighed down by a purulent infection, broad-spectrum antibiotics are prescribed in tablets - Ampicillin, Oxacillin, Macropen, Levomycetin, Azithromycin, etc.
When using ointments, it is strictly forbidden to apply them to places with open lesions (scratches, wounds, burns), so as not to cause additional damage with subsequent possible infection.
Physiotherapy
Professionals are well aware of how to treat knee bursitis. The complex of conservative methods of therapy includes physiotherapy. With the help of hardware action, edema is removed, pain is eliminated, blood supply and blood circulation improves, tissue regeneration processes are activated, joint mobility improves.
Effective methods:
- Electrophoresis with the use of medications.
- Laser therapy, UV radiation.
- Ultrasound therapy with the inclusion of non-steroidal ointments of anti-inflammatory action.
- Paraffin applications, etc.
Physiotherapy is contraindicated in purulent complications of the disease and tissue necrosis of the synovial bag.
Home doctor
Treatment of bursitis of the knee joint at home is carried out with the use of medications recommended by a doctor. This disease, even in acute form, does not require hospitalization. Surgical interventions are performed on an outpatient basis under local anesthesia, and after a few hours the patient can go home for further action.
The doctor will tell you how to treat knee bursitis at home, he will also write down a treatment regimen, give recommendations on behavior, take medications, and select a range of additional drugs. The main treatment requirements are:
- Compliance with complete motor rest until the end of the acute phase of the disease.
- Reception of anti-inflammatory drugs of steroid or non-steroid group.
- External therapy using ointments of anti-inflammatory, anesthetic effect.
- When persistent remission occurs, professional massage and exercise therapy are recommended.
In the complex of therapeutic measures, if there are no objections from a specialist, traditional medicine is included.
Alternative and folk methods of treatment
In folk medicine, a wide range of methods and tools are used to effectively treat knee bursitis.
Compresses:
- Cabbage leaf. A large fresh leaf of cabbage is separated, washed, large veins are removed and knead in hands until juice is obtained. The leaf is tightly wound to the affected joint, fixed. Every 4 hours, replace the sagging sheet with a fresh one. Cabbage relieves inflammation, swelling, reduces tissue temperature.
- Decoction of burdock root. In a warm broth, moisten the tissue and attach to the inflamed joint, fix and warm with a woolen cloth (the recipe is not suitable for infectious bursitis). The duration of the session is no more than 2 hours, therapy is carried out for 3 weeks. Recipe - pour 4 large spoons of dry root into two liters of water. Boil and leave on fire for 5 minutes. Let it brew, cool.
- Saline solution (1 large spoon of table salt + 0.5 liters of boiled warm water). The natural fabric is impregnated with a solution and wrapped around the knee, insulated with woolen material. It is recommended to do before bedtime to cure bursitis of the knee joint.
Treatment with folk remedies to strengthen immunity and eliminate inflammation involves taking phytopreparations inside:
- Alcohol drops - 4 large spoons of dry St. John's wort grass are poured into a dark glass bottle and poured with 4 glasses of medical alcohol. Insist in a darkened room, periodically shaking the container, for two weeks. Take 25 drops of tincture, diluted with water. For successful therapy, three doses per day are sufficient. The duration of treatment is at least 10 days.
- Willow bark - take 2 large tablespoons of finely chopped bark, pour boiling water (400 ml), leave for 30 minutes. Strain the composition. Recommended intake of 3 teaspoons of the elixir three or more times a day.
- Propolis (30 g) mixed with natural butter (200 g). Take a teaspoon of the product before meals for a week. The same recipe is used for external use - the ointment is rubbed into the inflamed joint, a light massage is made after the inflammation is eliminated.
There are a large number of ways to help overcome knee bursitis. Alternative treatment suggests using this option - fill a small bag with flax seeds and apply it overnight to the affected joint. A good result for relieving inflammation is shown by applying frozen Kalanchoe leaves to the knee, it is advisable to fix the compress overnight.
Prevention
The following measures help to avoid relapse of the disease:
- Moderate physical activity on the knee joints.
- Regular performance of a special complex of exercise therapy, with a gradual increase in load and the number of repetitions.
- In sports, give preference to swimming.
- Use knee braces (periodically).
- Preventively undergo a course of physiotherapy and massage 2 times during the year.