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Pes Anserine Bursitis 2 1/2 years post R TKR

Posted by loulou13 @loulou13, Jul 8, 2025

I had a right total knee replacement in September of 2022 I seemed to do fine until the beginning of this year. Started to experience pain below my knee on the medial side. After about 2 months of it not resolving I went to the orthopedist who performed my surgery he started me on meloxicam and gave me a knee support and started physical therapy. I saw him for a follow-up 5 weeks later and the pain was still there he gave me PRP injection into the pes anserine Bursa. I returned 2 weeks later and received another injection at the same site. I am now 4 weeks post last injection. I am still having pain localized to that site and sometimes it feels as though it is affecting the whole knee joint. I am continuing physical therapy but I really do not think it is helping I am a retired PT myself and I can do most of the exercises at home. I go back to the orthopedist in 2 weeks which makes it 6 weeks post last injection Maybe I should not be expecting the pain to be resolved by now but the pain since the injection into the bursa seems worse than it did before the injection. Is this still part of the healing process?
If I take an advil or anti-inflammatory am I interfering with the process of healing?

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genie15 | @genie15 | Jul 9, 2025

Bursitis is really hard to get rid of, isn't it? I have had it now for months and also had a TKR. My physical therapist wanted me to do more therapy exercises, but everything I did seemed to make the symptoms worse. I dropped a lot of therapy exercises that required weights and straps and standing on 1 foot. That helped, but I didn't know to stop the indoor bike. Later I learned that repetitive strain on the knee makes bursitis worse, not better. All I do now is walk slowly for short distances 2-3 times a week. Finally I was able to see the physiatrist who fixed hip bursitis for me a year or so ago. When diagnosing he didn't have to get imaging. He has been in practice for 30 years. He asked about my symptoms and then reached over and put a finger on either side of my knee and squeezed ever so gently. I yelped and he said it was pes anserine. Then we talked options and went to shockwave as a first choice for treatment. This injury is more extensive and older than the hip was, so after 4 treatments I am only mostly healed, while the hip was cured in 4 sessions. If you decide to try shockwave, know that you can't take NSAIDs or cortisone while you're doing it. Shockwave gives pretty rapid relief after the second treatment. It's not covered by insurance, but personally I feel so much better so much faster that I don't mind paying out of pocket. Best wishes to you in your search for relief!

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loulou13 | @loulou13 | Jul 9, 2025
In reply to @genie15 "Bursitis is really hard to get rid of, isn't it? I have had it now for..." + (show)
Profile picture for genie15 @genie15

Bursitis is really hard to get rid of, isn't it? I have had it now for months and also had a TKR. My physical therapist wanted me to do more therapy exercises, but everything I did seemed to make the symptoms worse. I dropped a lot of therapy exercises that required weights and straps and standing on 1 foot. That helped, but I didn't know to stop the indoor bike. Later I learned that repetitive strain on the knee makes bursitis worse, not better. All I do now is walk slowly for short distances 2-3 times a week. Finally I was able to see the physiatrist who fixed hip bursitis for me a year or so ago. When diagnosing he didn't have to get imaging. He has been in practice for 30 years. He asked about my symptoms and then reached over and put a finger on either side of my knee and squeezed ever so gently. I yelped and he said it was pes anserine. Then we talked options and went to shockwave as a first choice for treatment. This injury is more extensive and older than the hip was, so after 4 treatments I am only mostly healed, while the hip was cured in 4 sessions. If you decide to try shockwave, know that you can't take NSAIDs or cortisone while you're doing it. Shockwave gives pretty rapid relief after the second treatment. It's not covered by insurance, but personally I feel so much better so much faster that I don't mind paying out of pocket. Best wishes to you in your search for relief!

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Thank you so much for this valuable information!!
I will look into my options!!

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pah17 | @pah17 | Sep 2 8:08pm
In reply to @genie15 "Bursitis is really hard to get rid of, isn't it? I have had it now for..." + (show)
Profile picture for genie15 @genie15

Bursitis is really hard to get rid of, isn't it? I have had it now for months and also had a TKR. My physical therapist wanted me to do more therapy exercises, but everything I did seemed to make the symptoms worse. I dropped a lot of therapy exercises that required weights and straps and standing on 1 foot. That helped, but I didn't know to stop the indoor bike. Later I learned that repetitive strain on the knee makes bursitis worse, not better. All I do now is walk slowly for short distances 2-3 times a week. Finally I was able to see the physiatrist who fixed hip bursitis for me a year or so ago. When diagnosing he didn't have to get imaging. He has been in practice for 30 years. He asked about my symptoms and then reached over and put a finger on either side of my knee and squeezed ever so gently. I yelped and he said it was pes anserine. Then we talked options and went to shockwave as a first choice for treatment. This injury is more extensive and older than the hip was, so after 4 treatments I am only mostly healed, while the hip was cured in 4 sessions. If you decide to try shockwave, know that you can't take NSAIDs or cortisone while you're doing it. Shockwave gives pretty rapid relief after the second treatment. It's not covered by insurance, but personally I feel so much better so much faster that I don't mind paying out of pocket. Best wishes to you in your search for relief!

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@genie15
Well, that's depressing. I'm on Prednisone for Polymyalgia Rheumatica and I've developed
acute knee pain with a tender spot on the inside of my knee. I did have an x-ray at Urgent Care which showed meniscal calcium crystals. Rheumatology does not think that is enough to give me this degree of pain. He's taking a gander that it is Pes Anserine Bursitis and gave me a Cortisone injection in hopes that it will relieve the pain. He also ordered an MRI in case that doesn't do the trick. By the way I have no visible swelling or warmth. I thought maybe he could drain the knee to relieve pressure and analyze the fluid. He didn't think there was enough.
Maybe I should be grateful that at age 74 this is my first experience with knee issues.
Since I haven't had any prodedures/surgeries do you think I might have a full recovery sooner than later?
I'm missing work. Since I'm a cashier which includes twisting, turning, lifting and bagging, I fear it'll be a while before I can manage my duties. It hurts like hell.

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