After a fall, the wound heals but the pain in his knee persists. What to do?

Q. I was rollerblading a month ago and fell directly on my left knee. When I landed, I had severe pain on the front of my knee. The abrasions healed, but I have persistent swelling and have been unable to return to sports. X-rays at an urgent care showed no fracture. Is it unusual that I still have this much pain and swelling one month post injury with negative X-rays? What should I do to get better?

A: Since you are still symptomatic, I recommend you see an orthopedic surgeon.

One possible reason for your persistent pain and swelling may be a prepatellar bursitis. The bursa is a tissue structure in the front of your knee located between the skin and the kneecap. If traumatized, the bursa can fill with fluid, which can limit motion and cause pain.

Another possible cause may be a bone bruise of the kneecap or end of the femur. The bone bruise can cause swelling, pain, and difficulty walking up and down stairs or getting out of a chair.

It is also possible you damaged the cartilage on the backside of the kneecap that can cause pain and swelling. In addition to examining your knee, the physician may order additional X-rays or an MRI as an to help establish the type and degree of injury. These injuries may have different treatment plans and timetables to a return to sports.