Prepatellyarny bursitis - a disease characterized by tissue damage and inflammation of the joint of the knee bag (a small sac filled with fluid, which is located between the kneecap and the skin).The main symptom of bursitis - a pain in the affected area.
There are several types of bursitis of the knee joint, depending on the involvement of inflammation of a joint capsule.
addition prepatellyarnoy bags in the knee area, there is also suprapatellyarnaya joint capsule, which is located at the junction of the knee cartilage.Its inflammation is called bursitis suprapatellyarny.However, despite the different names, disease symptoms are almost identical.
most common factors leading to the development of bursitis of the knee are:
- Permanent and long-term exercise with the involvement of the knee or with strong pressure in this area
- direction of impact, falling on his knees
- Infectionsat the site of a cut or abrasion on
- knee excessive burden on the knees with concomitant obesity
- presence in a patient of infectious diseases (syphilis, tuberculosis, brucellosis, gonorrhea, etc.)
- Training in extreme conditions (with an increased risk of injury)
Development of inflammation in the knee joint is typical not only for athletes.This condition can develop in every person, even after minor trauma:
- famous actor Tom Hanks in 2013 underwent surgery for bursitis of the knee joint, and even took the treatment process
- video In 2011, singer Barry Manilow underwent surgery for complications prepatellyarnogobursitis."The good news: after several weeks of nightmare, I finally rose from the dead.I'm slowly beginning to walk, yet with a crutch, but soon get better eventually »
knee bursitis are classified:
- According to the clinical course of chronic, sub-acute, acute bursitis
- By pathogen: on nespretsifichesky and specific (tuberculous bursitis, whengonorrhea, syphilis, brucellosis).The same classification is sometimes divided into infectious and aseptic (non-infectious)
- By the nature of exudate:
- bursit- hemorrhagic fluid in many erythrocytes
- serous - in the liquid plasma with an admixture of blood cells
- purulent - the presence of white blood cells broken, destroyed cellsmicroorganisms
- fibrinous bursitis - a high content of fibrin
mainly characterized bursitis of the knee symptoms include gradually increasing pain and swelling directly in front of the kneecap.In less severe cases, swelling can be observed, and the patient worries stiffness, increasing during prolonged physical activity.At the initial stage of pain, on the contrary, may subside as improving blood flow in the area of the joint, ie at moderate loads the patient's condition may improve.
Among other features:
- Inability to fully straighten the leg at the knee joint;
- Pain when touching the area of the patella;
- pain when walking (usually on an inclined surface - rise or descend from the mountains, etc.);
- edema, induration, redness and local temperature rise in the area of the joint (signs of inflammation).
pain occurs just above the kneecap and can be spread on the back of the knees and inner thighs, and up or down the leg.Pain increases with crossed legs, as well as the rise after a long sitting in one position.Sick prepatellyarnym bursitis can not kneel.
indirect symptom is a violation sleep.This is due to the fact that the pain in the legs bending or change in body position can be amplified significantly, depending on the severity of inflammation.Many patients, based on their own feelings, recommended sleep time to put between your knees (and hips) pillow.
Limitation mobility occurs with the progression of the disease, when undertreated inflammation becomes more marked, causing severe pain when bending the legs.Over time, the affected limb develop muscle weakness and degeneration.
In acute bursitis:
- in bags field formed swelling, rounded, painful, elastic
- appears redness, soft tissue swelling and pain
- restricts the movement of the joint
- The patient may be a general malaise and rising temperature
- then increased redness, pain increases, the temperature can reach 40C
- Perhaps the development of purulent process, cellulitis
timely and correct treatment of acute bursitis stops the progression of the disease, and it does not go into sub-acute and then chronic.
- movement in the joint is not limited
- In the bag - round mild swelling
- But pain, redness and swelling of the surrounding tissue is not
- In chronic course may relapse (injury, decreased immunity)
Prepatellyarny bursitis - the most frequent, and the inflamed subcutaneous pouch on the anterior surface of the knee.The reason may be padagrichesky arthritis, deposition of salts in the psevodopodagre, rheumatoid arthritis, and often occurs after injury, trauma, falling to one knee or professional, if the work requires frequent kneeling.Unlike arthritis pain is not very pronounced and movement restriction is not significant.When infected contents into the cavity of the bursa swollen lymph nodes, pain increases, the body temperature rises.
infrapatellar bursitis - occurs due to inflammation of the bursa beneath the tendon below the kneecap, often develops after jumping or trauma.Treatment consists of rest, cold compresses, taking NSAID pain medications.
Goose bursitis (Baker's cyst) - inflamed bursa, located behind the internal surface of the knee joint.Most often it occurs in women with excess weight, accompanied by pain, which is more pronounced when descending or climbing stairs.
prepatellyarnogo Most cases of bursitis treated with physiotherapy.The frequency of positive results is largely dependent on the participation of the patient.One of the key components of the treatment is sufficient rest after any physical activity, which has led to increased pain.
If after physiotherapy there is a deterioration, it is necessary to exclude TB disease etiology as massage, heat treatments and physiotherapy lead to a deterioration and progression of the disease at extrapulmonary forms of tuberculosis.
actions, has a pronounced irritant effect on the joint capsule of the knee joint, should be kept to a minimum.As soon as the patient feels that can perform these actions without concomitant pain, gradual recovery in activity will mean that a further rise of gravity is not, and the patient's condition improves.
Ignoring the symptoms of, or attempt to adapt to the pain can lead to the transition of the disease into a chronic form.Therefore it is important to begin treatment immediately, regardless of the severity and the condition of the patient.In
when the disease becomes chronic, significantly slows down the healing process and increases the likelihood of recurrence in the future.
Treatment of bursitis of the knee joint in the initial phase takes place in the mode of: Ice - Peace - pressure - rise.This mode allows you to achieve a significant improvement if the event started within the first 72 hours after injury.
saving mode includes:
- load restriction can worsen the condition;
- Regular application of ice to the area of inflammation;
- application of compressive elastic bandages;
- Maintaining the affected limb in an elevated position (above the heart).
speed up the healing process can be anti-inflammatory drugs that have analgesic and anti-edema effect.
help in improving the course of the disease can help receiving manual therapy:
When properly conducted physical therapy, most cases with mild symptoms of the disease is usually cured with the restoration of normal functions in a few weeks.In more severe and chronic course of the reduction can be much longer.
Also, with the higher the likelihood that the patient will require additional interventions (corticosteroid injections).Early initiation of physiotherapy is essential to speed up the healing process and to ensure the optimal outcome of the disease with decreased likelihood of re-development.
an important role in the treatment play a special exercise:
- Static reduce internal head quadriceps
Tense muscles of the front of the thigh (quadriceps), brought under the knee small towel, trying to straighten the leg.Put his hand on the inside of the thigh, so you can feel the tension inside of the muscle during its contraction.Secure the leg in this position for 5 seconds, then relax.Repeat the exercise 10 times with the highest possible strength, but not leading to the appearance of symptoms.
- leg flexion and extension of the knee
flexion and extension of the leg in the knee joint with the maximum amplitude, but not leading to the appearance of pain.Repeat 10-20 times, provided that during exercise the symptoms do not grow.
Exclude from your exercise program squats, repeated bending at the knees, crossing legs and other similar exercises.
Bursitis of the knee joint to be treated had no effect, may require surgical intervention in the form of aspiration (suction) of the contents of the joint capsule and the introduction into it of corticosteroids.
This procedure is carried out using a thin needle under local anesthesia.After draining the joint capsule doctor may enter into her hormones - corticosteroids.This is necessary in order to halt the inflammatory process.Then you need to continue wearing the elastic bandage and ensure lasting peace limb (usually 48 hours).This treatment is much more effective than treatment with drugs (NSAIDs), since the tablet form have a general effect on the body, often without penetrating into the joints.
In rare cases, the treatment is not effective, and the only solution is surgical removal prepatellyarnoy joint capsule.Restoration of normal joint function after such an operation takes place within a few days, and return to normal life without the constraints of physical activity can be realized in 2-3 weeks.
If bursitis is an infectious origin (the penetration of bacteria into the joint capsule), for the prevention of septic complications is necessary to early treatment with antibiotics.Selection of the drug is based on the determination of susceptibility.If after treatment the disease continues to progress, the joint capsule is opened, and purified by surgery.
Ointments for topical
addition to knee pads to improve the condition, removal of edema, inflammation and pain can be used treatment ointments with anti-inflammatory ingredients (see more detail in the ointment in pain.):
- Fastum-gel-based non-steroidal anti-inflammatory drugsIt is very effective for quick removal of edema, has analgesic effect;
- Nise gel, the same mechanism of action;
- Finalgon and analogues - improve blood circulation to the site of application, contribute to the removal of edema;
- ointments with menthol (Bom-Benge, Ben-Gay et al.) - Anti-inflammatory effect with the cooling effect of distracting.
use of new products - knee Knee Inferno Wrap
novelty on the market of auxiliary medical devices is the knee Knee Inferno Wrap®, stimulating local blood flow due to radiation exposure in a certain range.
device emits light in the range, almost the same with sunlight.Due to this additional energy is produced, the body gets sick and is used to enhance the recovery processes.
Since the device operates locally, the flow of energy penetrates deep into the joint capsule, and contributes to the rapid removal of toxins, dead cells and accelerates the growth of new tissue, improving its elasticity.
There are some simple tips on how to prevent such unwanted diseases:
- Wear kneepads.This is especially important for people with an increased risk of injury (football players, basketball players, wrestlers).There are special cooling knee with pockets for ice packs;
- Regularly let the feet rest.To avoid long-term stress on the knees need to constantly change the appearance and intensity of physical activity;
- After training, apply ice and give the legs elevated position.