Right knee repeatedly injured: Prepatellar bursitis

Patient

Q: Let me start from the beginning. About 9 years ago I was playing basketball in gym class in high school. I was running down the court and went to plant my right foot and hyperextended my knee. It swole up immedietley and hurt BAD. I iced it down and the swelling and pain went away in a matter of a couple of hours. I could walk okay on it a couple days later. Fast foward 4 years later. I was up high on stilts finishing drywall, when I tripped over an extension cord and came down right knee first on a concrete floor. Again it hurt BAD and I couldn't straighten my leg for 2 days. I also noticed a fluid sack on my knee. It felt like a water balloon when I pushed on it. When I was able to walk on it again, I went to kneal down to pick something up and I felt the fluid sack pop. It litterally felt like a water balloon popping in my knee. Ever since the last injury I've noticed that my knee feels very weak like it could give out on me. Especially when I'm active. I also get pain on the sides of my knee and at the top of te knee cap. I never saught medical attention for either injury. What could this be and should I see a doctor?

Doctor

A:   Most likely you had a liquid collection in your prepatellar bursa produced by the previous traumatism.The prepatellar bursa is a superficial bursa with a thin synovial lining located between the skin and the patella. Normally, it does not communicate with the joint space and contains a minimal amount of fluid; however, inflammation of the prepatellar bursa results in marked increase of fluid within its space. The recommended treatment would be: after the initial period of rest, physical therapy is started to regain any loss of Range Of Motion, while increasing the flexibility and strength  of the quadriceps and hamstrings. Emphasize education on the  avoidance of kneeling, and use of kneepads if kneeling is necessary.

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