Long-term follow-up of corticosteroid injection for traumatic olecranon bursitis.

Abstract

SUMMARY Forty-seven patients with traumatic olecranon bursitis were evaluated after a mean follow-up of 31 months (range 6 to 62 months). Twenty-two patients treated with bursal aspiration had delayed recovery and no complications of therapy. Twenty-five patients treated with intrabursal injection of 20 mg of triamcinolone hexacetonide had rapid recovery, usually within one week, but suffered complications such as infection (3 cases), skin atrophy (5 cases), and chronic local pain (7 cases). Since spontaneous resolution can be expected, a conservative approach is suggested in the treatment of traumatic olecranon bursitis.While the clinical' and radiological2 findings in traumatic olecranon bursitis have been described in detail, the clinical course and long-term results of therapy remain largely unknown.We report here the outcome of treatment of 47 consecutive patients with traumatic olecranon bursitis treated with bursal aspiration alone or aspiration followed by corticosteroid injection.

A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis

“…Moreover, aspiration itself might cause new mechanical injury to the bursa and initiate another inflammatory process, which may explain the higher recurrence rate of nonseptic olecranon bursitis. On the contrary, compression/ NSAIDs may be chosen at ease for the treatment of nonseptic olecranon bursitis because the inflammatory process might subside with time if there is no further damage to the bursa [20]. The relatively low proportion of failed resolution (17%) at 4 weeks obtained in Group C supports the efficiency of compression/NSAIDs in the treatment of nonseptic olecranon bursitis.…”

“…Moreover, a study of this size cannot draw any inferences about safety nor can it compare the groups in terms of safety [10]. It is important to note that prior studies have amply documented the sometimes severe risks of injections and aspirations of olecranon bursae [8,17,18,20]. Based on these concerns, and on the absence of large differences among our study groups, we consider that compression bandaging and short courses of NSAIDs may be the safest approach for these patients and more invasive modalities be reserved for those patients who have failed such treatment [8,20].…”

“…Although the proportions of resolution were not different between the compression/NSAIDs group (Group C) and the steroid injection after aspiration group (Group AS), the AS group showed a slightly faster time to resolution compared with the other groups. Previously, Weinstein et al [20] observed faster resolution of olecranon bursitis in patients undergoing intrabursal injection of triamcinolone compared with those undergoing initial aspiration and subsequent observation. This rapid and prolonged effect of steroids on bursitis has also been reported for trochanteric bursitis [16] and subacromial bursitis [9].…”

“…To the authors' knowledge, there are few studies comparing the results according to the treatment methods for nonseptic olecranon bursitis [13,20]. The establishment of an evidence-based treatment guideline for nonseptic olecranon bursitis would be an important step, but data from randomized trials should support any such guidelines [15].…”

Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland

“…Smith et al [18] conducted the only randomized controlled trial on this treatment option and found a faster decrease in swelling and fewer re-aspirations for intrabursal methylprednisolone injections compared to oral naproxen or oral placebo in 42 male patients with NSB, which is in line with orther studies [3,23]. Although Smith et al [18] reported no complications, other authors have, including skin atrophy, chronic local pain, or infection [3,20,23].…”