Non-Septic Infrapatellar Bursitis: What to Do When Aspiration Did Not Resolve Persistent Knee Swelling

This protocol addresses aseptic (non-septic) infrapatellar bursitis in patients where an initial bursal aspiration procedure was performed but did not achieve resolution of persistent knee swelling — and a next treatment step is required.

Clinical scenario

The patient has infrapatellar bursitis confirmed as non-septic. For most cases of aseptic (non-septic) bursitis, conservative management is effective; however, this patient has not responded adequately to the first-line intervention.

Previous step — target not reached

Aspiration of bursal fluid from the infrapatellar bursa under sterile conditions was carried out but did not achieve the required goal of resolving persistent knee swelling, triggering escalation to this next-line protocol.

Next-line approach (partial overview)

When aspiration has been insufficient, an injection-based intervention targeting the infrapatellar bursa is indicated — directed at achieving resolution of knee inflammation. The complete regimen, eligibility criteria, and procedural details are available in the full structured protocol.

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References

For most cases of aseptic (non-septic) bursitis, conservative management is effective.

If inflammation persists despite these measures, corticosteroid injections can be administered directly into the bursa.

These injections are effective in reducing inflammation but should be used cautiously to avoid adverse effects, such as tissue weakening with repeated use.

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