Bursa problem

[ern]

Its been 7 weeks since tkr and things are moving along ok. When I last visited the OS I asked him what the hard swelling lump was above the patella. He told me that it was a bursa, (bursitis)sac of fluid that lubricates the knee joint and that it would disappear in time. I had the swelling down at one stage but excercise seems to aggravate it. I am hopeing that someone might suggest something to help with swelling reduction. Thankyou all very much,
Ern.

 

[Josephine]

Well, exercise WILL aggravate it but don't let that worry or stop you. Joints have this natty self-lubricating system. The lining of the joint is a membrane called the synovium. It produces a fluid called (surprise, surprise) synovial fluid which is quite viscous, about the same consistency as egg white. The membrane will detect extra movement and produce just the right amount of fluid to keep the joint healthy.

When a joint is diseased (like with o/a), has been interfered with or had foreign bodies in it (like a TKR), then the delicate sensory system gets out of kilter and it can over or under produce. Underproducing is one situation that can lead to the need for a manipulation (only one and not the most common) whilst overproduction can lead to bursas such as you describe.

Now the joint capsule is not a completely enveloping structure. It has gaps and weaknesses in it. There's nothing wrong with that, it's quite normal anatomy, but the synovial membrane IS completely enveloping and is also quite soft and stretchy so naturally where it goes across those gaps in the capsule, it will bulge out like a little balloon, especially if there is more fluid in the joint than usual. This is what we call a bursa.

There are particular points where bursae are present being just above and just below the patella (supra-patellar and pre-patellar) and behind the knee which is commonly called a Baker's cyst (Mr Baker being the anatomist who first described it).

The thing to remember is that these are normal anatomy and only become a problem when they get filled with fluid enough to either get notice or cause pain or discomfort (or both!).



<end of lecture>!!

 

[ern]

Thanks Josephine,
It is starting to get better and with a little luck things may be turning for the better. I value your support, what a wealth of infomation to all of us, God Bless You.
Ern.