Summary

Arthroscopic olecranon bursectomy in the treatment of recalcitrant olecranon bursitis shows promise as a safe procedure with minimal complications and no instances of wound failure, recurrence, or returns to the operating room.

Abstract

Introduction

Traditionally, the gold standard for the treatment of recalcitrant olecranon bursitis has been an open bursectomy. Recently, arthroscopy has been proposed as an alternative method. However, there is a paucity of literature regarding outcomes of arthroscopic olecranon bursectomy. This study seeks to assess the rates of complications after arthroscopic olecranon bursectomy.

Methods

A retrospective analysis was conducted on patients who underwent an arthroscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis between January 2018 and May 2021 at the senior author’s practice. Included patients had an average follow-up time of 19.6 months. Demographic variables as well as characterizations of the olecranon bursitis such as aseptic, septic, and gouty tophi were recorded. Additionally, any complications such as infection, recurrence, wound failure, or hospitalizations were documented.

Results

Our study included 28 patients with an average age of 68 years, all of whom had follow up. The average follow-up was 19.6 months. There were 15 cases (54%) of aseptic bursitis, 13 cases (46%) of septic bursitis, and 7 cases (25%) which contained gouty tophi (5 aseptic and 2 septic). Of the 28 patients, 4 experienced complications. These all occurred within 3 months of surgery. One necessitated hospitalization and IV antibiotics, 2 were minor infections treated with oral antibiotics, and one was swelling treated successfully with in-office aspiration. Overall, 86% of patients reported a rapid recovery with no issues at all related to the surgery. Amongst all the included patients, there were no instances of recurrence, wound failure, or secondary operations.

Conclusions

Our data shows that arthroscopic olecranon bursectomies are safe and effective with minimal complications in a primarily elderly population. This includes being effective in septic cases and cases which involve gout and gouty tophi. Further, there were no instances of wound failure, recurrence, or returns to the operating room in any of our cases.