OrthoPro Clinic: Prepatellar Bursitis: What to Know About Housemaid’s Knee

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If you’ve ever knelt to garden, scrub a floor, or work on a DIY project and later noticed swelling and pain right at the front of your knee, you’re not alone.

This condition, commonly known as housemaid’s knee, has been recognised for centuries. It was initially seen in domestic workers who spent hours on their knees cleaning.

In medical terms, a housemaid’s knee is prepatellar bursitis, inflammation of the bursa (a small fluid-filled sac) in front of your kneecap.

When irritated, this bursa swells, causing pain, tenderness, and difficulty with everyday movements like bending, squatting, or even walking.

In this blog, we’ll break down what housemaid’s knee is, why it develops, and the symptoms you shouldn’t ignore. You’ll also discover the most effective options for housemaid’s knee treatment, from simple self-care to medical management and safe exercises to aid recovery.

By the end, you’ll know how to spot, treat, and prevent this condition so your knees stay healthier for the long run.

What is Housemaid’s Knee?

There are four bursae around the knee, and any can become inflamed, but the prepatellar bursa, which lies superficially over the patella, is the most commonly affected.

When irritated by pressure, trauma, or infection, it fills with extra fluid and becomes painful and swollen. Historically linked to domestic workers who scrubbed floors on their knees, it’s still common among gardeners, carpet layers, roofers, plumbers, mechanics, and athletes.

What is Bursitis?

A bursa cushions areas where tendons and ligaments pass over bone. Bursitis is simply inflammation of that sac.

As inflammation rises, fluid accumulates in the bursa, causing visible swelling, warmth, and tenderness. That swelling typically appears as a “pillow” of fluid right before the kneecap in the knee.

How Common is Housemaid’s Knee?

Prepatellar bursitis can occur at any age and is more common in men. Occupational kneeling raises the risk.

About one-third of cases are septic (infected) and two-thirds non-septic, with infection more frequent in children and in people with weakened immune immune systems (e.g., those on chemotherapy or long-term steroids).

Housemaid’s Knee Symptoms

Common housemaid’s knee symptoms include:

Swelling directly over the kneecap (often obvious and squishy) Pain and tenderness, worse with kneeling, squatting, or bending Warmth/redness; fever can occur if infection is present Stiffness and difficulty in fully bending the knee Pain with walking when swelling is pronounced

What Causes Housemaid’s Knee?

Repetitive kneeling/friction over the patella (most common) Direct blows or falls onto the front of the knee Infection (septic bursitis), often after a skin break allows bacteria (commonly Staph. aureus) into the bursa Inflammatory conditions such as rheumatoid arthritis Crystal arthropathies such as gout or pseudogout

Diagnosis

A clinician can often diagnose prepatellar bursitis by examining the knee and asking about your work, sport and recent injuries. Tests are used selectively:

Bursal aspiration (arthrocentesis) if infection is suspected; a small needle draws fluid to check for bacteria and guide antibiotic choice. Imaging (X-ray/MRI/Ultrasound) only if another problem (e.g., fracture, tendon injury) needs ruling out.

Housemaid’s Knee Pain Treatment

The housemaids knee treatment mostly needs supportive care and does not require surgery. Whether the bursitis is septic or non-septic, the treatment plan is tailored.

Clinic-Based Options (Non-septic)

Aspiration to decompress the bursa and relieve pressure. Corticosteroid injection into the bursa for persistent inflammation Physiotherapy to restore motion and strengthen support muscles

Treating Septic Bursitis

If the bursa is infected, understanding the septic prepatellar bursitis treatment guidelines is crucial:

Aspiration– To check fluid for culture and sensitivity.

Antibiotics– Regimens may include combinations such as flucloxacillin (± penicillin V) or co-amoxiclav, as the lab results Incision and Drainage- Incision and drainage are performed if symptoms does not improve within 36–48 hours of appropriate antibiotics or if fluid is loculated.

Surgery

For recurrent or chronic cases that don’t heal, arthroscopic/endoscopic bursectomy under local anaesthesia can remove the inflamed bursa.

Knee function remains intact without the prepatellar bursa, and recovery is generally smooth.

Housemaid’s Knee Exercises

When pain and swelling begin to settle, guided housemaid’s knee exercises help in recovery and reduce recurrences:

Gentle range-of-motion work to restore bend/straighten without provoking pain.
Quadriceps setting (static quads): Tighten the front-thigh muscles for 5 seconds, relax a bit, and repeat 10 times, 1–3 sets/day, pain-free only.
Quadriceps and hamstring stretches to reduce anterior knee friction.
Straight-leg raises to build support without compressing the bursa.
Low-impact cardio (cycling, swimming) to maintain joint mobility.
A physiotherapist can check the progress and recommend the exercises accordingly.

Prevention Tips for Kneecap Bursitis Knee pads or thick cushions for any task that involves kneeling.

Take frequent breaks and vary positions to reduce pressure on the patella. Warm up and cool down before/after sports.
Keep muscles flexible and strong, particularly quads and hamstrings.
Manage weight and skin health; treat cuts over the knee promptly to lower infection risk.

Outcomes Appropriate prepatellar bursitis treatment improves the outlook; most cases settle within a few weeks. The average housemaid’s knee recovery time is usually 2-6 weeks depending on severity and compliance with rest/treatment. If bursitis becomes chronic or recurrent, targeted physiotherapy, workplace modifications (knee protection), and, in select cases, an injection or day-case bursectomy can provide durable relief.

Visual Analogue Scale Anterior Knee Pain Scale: to measure the functions.

Why Choose OrthoPro Clinic?

At OrthoPro Clinic Dubai, we understand how frustrating and limiting joint pain and conditions like housemaid’s knee can be. That’s why we provide world-class, end-to-end orthopaedic care designed around you:

Comprehensive care under one roof – From diagnostics to treatment and rehabilitation, everything is available in a single, trusted centre.

Expert super-specialist surgeons – Our internationally trained orthopaedic surgeons are leaders in their sub-specialties, offering advanced, evidence-based care. Personalised recovery plans – Whether you’re a professional athlete or simply active daily, we focus on restoring your mobility in the least possible time. Cutting-edge rehabilitation facilities – Our state-of-the-art rehabilitation gym is one of the most comprehensive in the country, ensuring optimal recovery support. Compassionate, patient-focused approach – Beyond excellence in treatment, we pride ourselves on delivering care in a friendly, supportive environment.

At OrthoPro Clinic, our mission is to combine precision medicine with compassionate care, helping you get back to your best, faster and safer.

Moving Forward: Managing and Preventing Housemaid’s Knee

Housemaid’s knee (prepatellar bursitis) may sound like an old-fashioned condition, but it remains highly relevant today for anyone whose work, sport, or lifestyle puts repeated stress on the kneecap.

The good news is that with timely diagnosis, appropriate housemaid’s knee treatment, and guided rehabilitation exercises, most people fully recover in just a few weeks.

Preventive strategies such as using knee pads, taking regular breaks, and strengthening the muscles around the knee also reduce recurrences.

OrthoPro Clinic Dubai, combines world-class orthopaedic expertise with cutting-edge rehabilitation support to ensure you get the most effective care, whether you’re dealing with bursitis, an injury, or age-related wear and tear.

Book your consultation at OrthoPro Clinic today and let our experts help you get back to your best, faster and stronger.

Take the first step towards pain-free movement.

FAQ's

How do you treat housemaid’s knee?

Start with rest, ice, compression, elevation, (RICE) and appropriate NSAIDs/topicals. If swelling persists, your clinician may aspirate the bursa or consider a corticosteroid injection once infection is excluded. Antibiotics are required if the bursitis is septic; surgery is uncommon and reserved for recurrent, resistant cases.

What is meant by housemaid’s knee?

It is prepatellar bursitis, inflammation of the prepatellar bursa that sits between the skin and kneecap, typically triggered by kneeling, direct blows, or (less commonly) infection.

How do I get rid of bursitis in my knee?

Most people improve with activity modification, ice, compression, elevation, and physiotherapy. Persistent fluid may be aspirated, and stubborn inflammation can respond to a steroid injection (after infection is ruled out). Antibiotics is used to treat septic cases.

What does bursitis feel like in the knee?

A soft, tender swelling at the front of the knee that’s sore to kneel on, often warm and sometimes red. Bending or squatting can feel tight or uncomfortable; fever suggests possible infection