Category Archives: Injuries

Housemaid’s Knee (Prepatellar Bursitis) – Know the Signs and Symptoms

Housemaid’s knee is also known as prepatellar bursitis. It is caused by inflammation of the bursa (a small fluid-filled sac) in front of the kneecap. It more commonly occurs in people who spend long periods of time kneeling. Housemaid’s knee is more common in tradesmen who spend long periods of time kneeling -for example, carpet fitters, concrete finishers and roofers.

Any age group can be affected by housemaid’s knee. It is generally more common in males than in females. Housemaid’s knee in children is more likely to be caused by infection. Infection is also a common cause of housemaid’s knee in people whose immune systems are not working normally; people include those receiving steroid treatment or those on chemotherapy treatment for cancer.

What is bursitis?

Bursitis means inflammation within a bursa. A bursa is a small sac of fluid with a thin lining. There are a number of bursae in the body. Bursae are normally found around joints and in places where ligaments and tendons pass over bones. They can also be found in other places if there has been unusual pressure or friction placed on that area.

Generally, the function of a bursa is to help reduce friction and allow maximum range of motion around joints. When there is inflammation within a bursa (bursitis), the bursa swells due to an increase in the amount of fluid within the bursa sac.

 

What is housemaid’s knee?

There are four bursae located around the knee joint. They are all prone to inflammation, or bursitis. However, the prepatellar bursa (the bursa in between the skin and the kneecap) is most commonly affected. Its position is shown in the diagram. Housemaid’s knee is the name given to inflammation of the prepatellar bursa.

What causes housemaid’s knee?

There are a number of different things that can cause housemaid’s knee:

·      A sudden, one-off, injury to the knee – For example, a fall or direct blow on to the knee

·      Recurrent minor injury to the knee – This usually happens after spending long periods of time kneeling down, putting pressure on the kneecap (patella). Historically, this was typical of housemaids who spent long periods of time on their knees scrubbing floors; hence, the term housemaid’s knee.

·      Infection – The fluid in the prepatellar bursa sac can become infected and cause inflammation within a bursa (bursitis). This is particularly common in children with housemaid’s knee. This usually follows a cut, scratch or injury to the skin on the surface of the knee. This injury allows germs (bacteria) to spread infection into the bursa.

·      Another inflammatory disease – If you already have an inflammatory disease such as rheumatoid arthritis, you have an increased risk of developing a bursitis. Rheumatoid arthritis is a form of arthritis that causes inflammation, pain and swelling of joints.

·      Gout – If you have gout or pseudogout, you have an increased risk of developing a bursitis. Gout is caused by a build-up of uric acid crystals. Uric acid is a chemical in the blood that is usually harmless and passed out with the urine. In gout, it builds up and collects within a joint, causing pain, inflammation and joint swelling.

 

How is housemaid’s knee diagnosed?

Dr. Stickney is usually able to diagnose housemaid’s knee simply by examining your knee. He may ask you questions about your occupation or if you have had any recent knee injury and if you have any history of other joint problems.

If Dr. Stickney suspects that housemaid’s knee is caused by infection, he may suggest that they draw some fluid from the bursa. This is a straightforward procedure. The skin on the front of your knee is sterilized with some fluid and the procedure is carried out in a clean environment. A small needle is used to take a sample of the fluid from your prepatellar bursa, which is directly underneath the skin in front of your kneecap. This fluid is sent off to the laboratory to look for signs of infection. If infection is confirmed, the laboratory may be able to suggest which antibiotic medicines will treat it.

Treatment options for Housmaid’s Knee

Episodes’ of housemaid’s knee will settle with medical or supportive treatment unless infected, in which case, your Dr. Stickney may draw fluid, send for lab tests and prescribe some form of antibiotics. Drug or surgical treatment is determined in the treatment plan if the injury is recurring and/or infection is extreme.

If you are suffering from housemaid’s knee, call Dr. Stickney and schedule an appointment at 425-823-400 or email him at ProOrthoAppointment@proliancesurgeons.com.

ACL Prevention and Treatment

Spring is the perfect time to get outdoors to play tennis, basketball, soccer or even take up running.  Being active requires our bodies to adjust to the season once again and the providers at ProOrtho want to make sure that you are not sidelined from enjoying your favorite outdoor activity this season!

The ACL (anterior cruciate ligament (ACL) is one of four major ligaments that provide stability to the knee joint. It is located in the center of the knee and prevents the tibia (or shin bone) from sliding forward in relation to the femur (or thigh bone) and also prevents abnormal rotation of the knee. ACL injuries most commonly occur in sports that require cutting, pivoting, and quick stops like soccer and basketball.  Often the injury occurs without contact.

Immediately after an ACL injury, your knee may swell, feel unstable and may become painful when weightbearing. Many people hear or feel a “pop” in their knee when an ACL injury occurs.

Depending on the severity of your ACL injury, treatment may include surgery to replace the torn ligament followed by rehabilitation exercises to help you regain strength and stability.   When ACL injuries are left untreated your knee may feel unstable and if you continue to play cutting and pivoting sports it can casue further damage to your knee like meniscus tears and cartilage damage.

If your favorite sport involves pivoting or jumping, a proper training program can help reduce your chances of an ACL injury.   ACL prevention programs have been shown to decrease the risk of ACL injuries in female athletes.

ProOrtho offers the following tips on how to prevent an ACL injury:

  • Learn how to move with good alignment so you protect your knees.
  • Develop body awareness, strength, and balance to support your knees and ankles. Always jump, land, stop, and move with your knees directly over your feet.
  • Do NOT let your knees collapse inward.
  • Cut, pivot, and land from jumps with your knees more bent
  • Develop strength in your hips and thighs.
  • Warm up and stretch before games and practice.
  • Perform a variety of drills until the movement patterns are second nature and you don’t have to think about it.

By improving your flexibility, strength (particularly of the core, hips, and legs), balance, agility, and your ability to jump and land safely, you have less a chance of being injured.

According to Dr. Clinton, “all athletes in at risk sports, especially girls and women, should participate in an ACL prevention program.  This is the one thing that you can do that has been proven to prevent ACL injuries. “

If you are suffering from an ACL injury, call ProOrtho and schedule an appointment with one of their physicians at 425-823-400 or email them at ProOrthoAppointment@proliancesurgeons.com.

Orthopedic Injuries Related to Spring and Tips to Avoid Injury

When the rain showers subside here in the Pacific Northwest, we all love to take advantage of the great outdoors.  Cleaning the rain gutters, mowing the lawn, moving furniture or gardening may present injuries.  Let’s face it, when the sun comes out, we want to do everything outside!

Consider these statistics:

  • According to the U.S. Consumer Product Safety Commission, more than 35,500 people injured themselves while using a stepladder.
  • More than 41,000 Americans injured themselves while gardening or using gardening equipment
  • More than 127,000 people were injured while operating a lawn mower

Many common injuries, including tendonitis, sprains, strains or breaks, can be prevented with proper technique.  ProOrtho providers offer helpful tips for tackling all your spring plans:

  • Stretch – Stretch your arms, back and legs for several minutes before heading out to the garden or before cleaning out your basement or garage.
  • Squat – Avoid bending!  Make sure you are lifting with your legs. It’s important to squat when making a bed or shoveling dirt or mulch.
  • Lighten your load – When you are shoveling, try not to lift more than you can manage – This is when people tend to hurt themselves.  By using proper body mechanics, you may prevent an injury from occurring – Use your entire body to shovel; your hip and thigh muscles are some of the largest and strongest in the body, so put them to work.
  • Take a break –To avoid repetitive stress injury, rotate tasks that involve doing the same motions again and again (raking, digging) every 15 to 20 minutes and briefly rest or stretch in between.
  • Slide and push heavy or awkward objects.
  • Secure and stabilize a ladder before climbing.

According to Dr. Gregush, “The majority of injuries we see are preventable.  Take a few extra minutes to secure ladders before climbing on them and avoid repetitive activities.”

If you are suffering from a spring-related injury, call ProOrtho and schedule an appointment with one of our physicians at 425-823-400 or email us at ProOrthoAppointment@proliancesurgeons.com.