Rethinking Knee Pain: Biologic Therapies Show Promise for Stubborn Bursitis

Knee pain is often attributed to joints or ligaments, but a recent review suggests we might be overlooking bursae—small fluid-filled sacs that cushion movement. A systematic analysis of 76 studies covering 11 distinct knee bursae reveals that while these structures frequently cause pain, they remain under-recognised in clinical practice.

Traditionally, doctors manage bursitis with conservative treatments or corticosteroid injections. However, the review notes that steroid injections have recurrence rates between 20% and 40%. Enter biologic therapies, specifically Platelet-Rich Plasma (PRP), where a patient's own blood platelets are concentrated to promote healing. The data indicates that PRP, sometimes combined with hyaluronic acid, offers improved pain relief and lower recurrence rates compared to standard injections, particularly for pes anserine and osteoarthritis-related bursitis.

While promising, the science is not yet settled. High-level evidence supports PRP for common bursitis types, but data for rarer bursae relies on smaller case series. Consequently, researchers are calling for more high-quality randomised controlled trials to standardise these emerging protocols.