The prepatellar bursa allows the skin over the front of the knee to move freely during kneeling. Prepatellar bursitis (housemaid's knee) from occupational kneeling produces a fluctuant anterior knee swelling that is superficial to the patella and separate from the knee joint (the bursa does not communicate with the joint in most cases). It is the most common acute bursitis requiring aspiration.
Allows anterior knee skin to glide over the kneecap during kneeling — the classic tradesmen's bursa
Prepatellar bursitis is managed by aspiration (confirming non-purulent fluid) and compression dressing. Septic prepatellar bursitis from direct skin trauma or bacteraemia requires aspiration, fluid culture, and antibiotics — surgical bursectomy for cases failing to respond to antibiotics. Chronic prepatellar bursitis in tradespeople requires padding, aspiration, and occasionally sclerosant injection or surgical excision.
Occupational kneeling-related prepatellar bursal swelling managed with aspiration, compression, and padding to prevent recurrence.
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