It is the complex structure of the joints that ensures the stability and functionality of the knee. In order to avoid excessive friction of the cartilage and bones, a certain lubricant is present in the joint, which is formed in the synovial membrane.
These peculiar capsules are lined with epithelium from the inside, which provides reliable protection against damage (associated with excessive movements) with the help of certain inversions called bursa or bags. When inflammation forms in this bag, the doctor diagnoses bursitis.
Treatment of bursitis of the knee joint in a hospital is carried out only if the lesion requires surgery. In other cases, physiotherapeutic procedures and a set of home activities are required.
Main reasons
Bursa filled with fluid are located near the knee joint. Inflammation in them can provoke such factors as:
- infection;
- concomitant diseases;
- injuries.
The main cause of inflammation is infection. In particular, the development of pathology can provoke staphylococci. With the subsequent development of the disease, an increased accumulation of purulent discharge is observed. With this type of knee bursitis, treatment is required immediately. Incorrect or untimely therapy can lead to sepsis, which may require amputation of the limb. A particularly severe stage of the disease even leads to death.
Inflammation can occur as a result of dislocation, rupture of ligaments, fracture. A traumatic type of bursitis can also develop in case of increased load on the joint. This type of disease responds well enough to treatment. In some cases, concomitant diseases, in particular such as arthritis or gout, are a provoking factor. Often, the pathology goes into the chronic stage.
Types of disease
Symptoms and treatment of bursitis of the knee joint largely depend on the type of inflammation of the periarticular bags. It is worth noting that inflammation can be aseptic and septic. Aseptic type of disease occurs as a result of various kinds of bruises, injuries, as well as joint diseases. A septic, or infectious, type of disease develops when pathogens enter the mucous bag.
The severity of inflammation largely depends on the reaction of the body. Depending on the characteristics of the pathology, bursitis is:
- serous;
- hemorrhagic;
- purulent;
- fibrinous;
- combined.
Depending on the localization of inflammation, doctors distinguish such types of bursitis as:
- prepatellar;
- suprapatellar;
- infrapatellar;
- goose.
With the prepatellar type of bursitis, inflammation occurs between the knee pad and the skin. This type of disease mainly occurs in people who often rely on the knee joint. Suprapatellar bursitis is diagnosed with inflammatory pathology in the area located above the patella. Tumors in this case can reach significant sizes.
Infrapatellar bursitis occurs in a bag located below the area of the knee joint. A similar type of disorder can occur with direct injuries to the joint. Goose bursitis manifests itself in the form of the formation of a benign tumor, which is localized on the inner or lateral surface of the joint.
In addition, in the medical literature you can also find the terms ossifying and anserine bursitis. The ossifying type of disease is characterized by the presence of seals in the knee. As a result of this, a limitation of joint mobility is observed. Anserine type of disease often develops in women suffering from overweight. Inflammation occurs in the internal cavity of the joint.
Stages
Symptoms and treatment of bursitis of the knee joint may vary slightly depending on the stage in which the disease is. Doctors distinguish such stages as:
- spicy;
- subacute;
- chronic
- recurrent.
The acute stage is characterized by the rapid development of inflammation, it is accompanied by swelling, intense pain, chills, as well as a deterioration in well-being.
The subacute stage is relatively easy, and the patient's condition quickly stabilizes. As a result, there is swelling in the affected area. The intensity of the pain decreases slightly, and it becomes dull.
The chronic stage is characterized by the fact that movements are limited, the bursa shells thicken, tissue fibrosis is observed. If timely treatment of bursitis of the knee joint is not carried out, then the bursa cavity is divided into several cavities, where necrotic areas will form.
In a recurring form, periods of exacerbation are replaced by periods of subsidence of pain.
Symptoms and signs
There are certain signs of bursitis, among which are:
- inflammation and joint pain;
- stiffness of movements;
- muscle weakness;
- swelling or slight redness;
- malaise and decreased performance;
- fever, headache.
Symptoms are mostly pronounced. In the chronic form of the disease, the symptoms may be somewhat blurred, however, during an exacerbation of inflammation, they are quite pronounced. Depending on the characteristics of different types of bursitis, the symptoms may vary slightly. At the first suspicion of the occurrence of the disease, you should definitely consult a doctor.
Diagnostics
To select methods for treating bursitis of the knee joint, it is necessary to initially carry out diagnostics to determine the characteristics of inflammation. One of the most important points of diagnosis is the puncture of the bag. If as a result of the study it was possible to obtain a clear liquid, then this indicates an aseptic type of inflammation.
The reason is the presence of pathogens when pus impurities are found in the fluid. Baker's cyst, or popliteal cyst, is also quite easily diagnosed due to its characteristic location, namely in the popliteal fossa. In the case of a popliteal bursitis, the doctor resorts to the instrumental method of diagnosis, namely:
- arthrography;
- ultrasonography;
- radiography.
In general, the diagnosis of such a disease is not a serious problem, therefore, it is enough for a specialist to conduct a general examination and palpation. To exclude the malignant process in the bursa region, a histological examination of the contents of the bag is prescribed.
In the presence of fever and other signs of intoxication, a blood test is prescribed, since it will detect an infectious lesion of the knee joint.
Treatment features
Treatment of bursitis of the knee joint begins immediately after establishing an accurate diagnosis and determining the type of inflammation, since the treatment of an infectious and non-infectious type of pathology is somewhat different. A non-infectious treatment regimen implies:
- ensuring complete rest of the affected limb;
- taking anti-inflammatory drugs;
- aspiration of fluid accumulated in the bursa cavity;
- the introduction of corticosteroids into the affected joint;
- the use of muscle relaxants.
Treatment of purulent bursitis of the knee implies the conduct of activities such as:
- antibacterial therapy;
- the use of anti-inflammatory drugs;
- bursectomy;
- elimination of purulent contents from the bursa cavity.
With any type of pathological process, physiotherapeutic procedures are prescribed, which include:
- paraffin baths;
- microcurrent therapy;
- massage;
- UHF
At the initial stages of the disease and as auxiliary methods of therapy, folk remedies are used. In especially severe cases, the bag is opened and the purulent contents are removed by surgical intervention.
Drug therapy
The action of drugs for the treatment of bursitis of the knee joint is aimed at reducing the existing symptoms, which is manifested in the form of swelling, pain, and inflammation. For this, such groups of drugs are used as:
- anti-inflammatory;
- analgesics;
- hormonal;
- muscle relaxants;
- medical blockade.
Anti-inflammatory drugs help to cope with pain. In addition, they help eliminate inflammation and reduce swelling. When bursitis is prescribed therapy with drugs such as "Diclofenac", "Ibuprofen", "Ketoprofen." Such drugs are used in the form of injections or tablets.
Analgesics are prescribed for the relief of painful sensations, however, it should be borne in mind that such drugs do not affect the inflammatory process. When treating bursitis of the knee joint with drugs, hormonal drugs are prescribed, in particular, such as Hydrocortisone, Methylprednisolone, Diprospan. Often, such drugs are injected directly into the joint cavity.
Muscle relaxants are prescribed to reduce muscle cramps. Such drugs include, for example, Baclafen or Diazepan.
Ointments are widely used to treat knee bursitis in acute inflammation. As part of such a therapeutic agent, an anti-inflammatory component must be present. In particular, Fastum Gel, Voltaren, Deep Relief are considered good remedies.
Folk techniques
Effective treatment of arthrosis and bursitis of the knee joint with folk remedies is aimed at implementing measures to strengthen immunity and normalize metabolism. A good effect is the intake of apple cider vinegar.
Puffiness can be eliminated with a compress made from burdock leaves. A decoction made from the crushed roots of the plant, which must be used as a compress, also helps. For the treatment of synovitis and suprapatellar bursitis of the knee joint, you can use tincture of propolis in vodka. The mixture is prepared in a proportion of 1:10 and infused for 5 days.
For therapy, you can use an ointment prepared on the basis of soap, honey, grated fresh onions. The resulting product must be applied to the knee and fixed with a film. It helps eliminate puffiness. To reduce inflammation, a compress of Kalanchoe leaves should be applied daily to the affected area.
For internal use, a celery broth, tincture of St. John's wort and burdock, grapefruit juice are well suited. You can fight painful sensations by applying baths with a decoction of pine needles. However, it is worth remembering that such a procedure can be carried out only after the acute period ends.
Physiotherapeutic procedures
Physiotherapeutic treatment of infrapatellar bursitis of the knee joint is quite common, however, similar techniques can be applied only in the absence of purulent congestion in the bursa. For therapy, ultrasound with anti-inflammatory drugs is used. The use of such techniques is recommended during the acute stage of the disease.
To eliminate the symptoms of anserine bursitis of the knee joint, treatment is carried out using various methods. In particular, they include drug therapy, physiotherapeutic procedures, folk methods, and surgery is also prescribed if necessary. The very first stage of therapy is the application of a fixative bandage, which reduces the intensity of pain.
Surgical intervention
If the patient was diagnosed with a purulent type of disease, then the bag is removed with subsequent drainage of the cavity. Then, the resulting liquid is sent for bacteriological examination to determine the causative agent of the disease and the appointment of antibiotic therapy. The bag is washed with antiseptic solutions and antibacterial drugs are introduced into it.
Baker's cyst is mainly treated with a conservative method, however, with a significant increase in size, patients are prescribed surgery, that is, the cyst is completely removed. Reviews about the surgical treatment of knee bursitis are mostly positive, since this method allows you to quickly eliminate the existing problem and prevent the development of dangerous complications.
Therapeutic gymnastics and massage
During the acute stage, massage is strictly contraindicated. After the pain subsides, a slight massage is allowed around the affected area. It must be used in combination with therapeutic exercises.
During the subacute stage, the patient should begin swinging and flexion-extensor movements. As the pain subsides, more complex exercises are gradually needed. During the training, all actions should be monitored by a rehabilitologist.
Diet food
With bursitis, nutrition should be aimed at reducing the weight of the patient, since increased pressure on the knee provokes the development of various joint pathologies. In addition to this, a diet with bursitis must necessarily include:
- products containing gelatin;
- sea fish, liver, seafood, chicken;
- dishes of pumpkin, zucchini and legumes;
- various vegetables and cereals.
To prevent exacerbation of the disease, patients need to wear protective knee pads, eliminate excessive stress on the joint and engage in acceptable sports.
Possible complications
If timely measures are taken to eliminate the disease, then the prognosis is quite favorable. However, if the treatment is carried out incorrectly or untimely, then the pathology can go into a chronic form, which is fraught with such consequences as:
- restriction of movements;
- frequent relapses;
- sensitivity to weather changes;
- arthritis, arthrosis.
In addition, the development of such dangerous consequences as osteomyelitis, sepsis, fistulas, lymphadenitis is possible. A complete loss of motor functions is also possible.
Prophylaxis
In order to exclude the appearance of the disease, it is recommended to observe the following rules:
- Do not ignore the maximum allowable load on the joints;
- protect joints from bruises;
- perform procedures that normalize blood circulation in the joints;
- treat with antiseptics damaged areas of the skin.
Compliance with all these simple rules will prevent the development of the disease and prevent relapse after treatment.