Nonseptic olecranon bursitis
Definition
Abnormal increase in fluid in the olecranon bursa
Most common inflammed of all 150 bursa in human body
Anatomy
Olecranon bursa
- bursal lining is poorly vascularized synovial lining
- allows skin to move back and forward with flexion and extension
Etiology
Repetitive microtrauma
Medical conditions
- 10,000 patients with olecranon bursitis
- increased risk males / hyperlipidemia / high BMI / older age / smoking
Nonoperative management options
Avoid trauma
Compression bandaging
NSAIDs
Aspiration
Cortisone injections
- RCT of 90 patients
- compression + A. NSAIDS B. Aspiration C. Aspiration + cortisone injection
- no difference between 3 groups at 4 weeks
- average resolution 85%
- earlier resolution with cortisone injection
Operative options
Open excision
Arthroscopic excision
Open bursectomy
Technique
Results
- open excision of 190 cases olecranon bursitis
- revision rate 12%
- more likely women / diabetes / rheumatoid
- 4% delayed wound healing
- 2% need a flap, more commonly rheumatoid arthritis
Endoscopic bursectomy
Technique
Arthroscopy techniques endoscopic bursectomy PDF
Infected olecranon bursa
Diagnosis
Most common S aureus (90%)
- redness, fever
Confirm by aspiration
- leucocytosis > 10,000 mm3
- > 50% neutrophils
Management options
Antibiotics
Aspirate + antibiotics
Surgical drainnage