Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm

Baumbach, Sebastian Felix; Lobo, Christopher M.; Badyine, Ilias; Mutschler, Wolf; Kanz, Karl‐Georg

doi:10.1007/s00402-013-1882-7

Cited by 108 publications

(80 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the rate of resolution failure (35%) at 4 weeks with aspiration was unacceptable, especially considering the fact that the corresponding rate was lower in the patients who were treated by compression bandaging with NSAIDs. Although the exact reason behind the high failed resolution of nonseptic olecranon bursitis after aspiration remains to be determined, it can be speculated that aspiration alone cannot eliminate or alleviate the already initiated inflammatory response in the bursa caused by friction of the posterior elbow or its overuse, leading to continuous production of bursal fluid [3]. 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.…”

Section: Discussionmentioning

confidence: 99%

“…(3) What factors are associated with treatment failure by 4 weeks? Methods We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each).…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

Kim

Chung

Kim

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. Questions/purposes (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? Methods We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. Results There were no differences in the proportion of patients whose bursitis resolved by Week 4 among the three treatment groups ( Conclusions With the numbers available, there were no differences in efficacy when compression bandaging with NSAIDs, aspiration, and aspiration with steroid injection were compared. However, we were powered only to detect a 30% difference, meaning that if there were a smaller difference in efficacy among the groups, we might not have detected it in a study of this size. Our data can be used as pilot data to power future prospective (and likely multicenter) trials. Because olecranon bursitis can recur, and because treatments like aspiration and aspiration with steroid injection can cause complications, unless future trials demonstrate clear efficacy advantages of aspiration and/or injection both at short and longer terms, we suggest that compression bandaging and a short course of NSAIDs may offer the most appropriate balance of safety and efficacy. Level of Evidence Level II, therapeutic study.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Kim

Chung

Kim

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Prädiktoren für den Übergang in eine chronische Bursitis sind uns nicht bekannt [4]. Bei der konservativen Behandlung steht das PRICE-Schema ("protection", "rest", "ice", "compression", "elevation") mit Immobilisierung über eine Woche im Vordergrund [16]. Steroidinjektionen über den lateralen Zugang scheinen bei sorgfältiger Abwägung der Komplikationen ihre Berechtigung zu haben [17,18,19,20].…”

Section: Cmeunclassified

“…Die Punktion von Flüssigkeit mit simultaner Kortisoninjektion kann die Rezidivrate reduzieren und wird von einigen Autoren empfohlen, ist allerdings mit erhöhten Komplikationsraten (iatrogene Infektionen, Hautatrophien) behaftet [21]. Die operative Versorgung sollte aufgrund von Wundheilungsproblemen und Rezidiven [16,22] chronischen Fällen von aseptischer Bursitis vorbehalten bleiben [23].…”

Section: Cmeunclassified

Behandlung der traumatisch eröffneten Bursa olecrani und der chronischen Bursitis olecrani

Saul

Dresing

2017

Oper Orthop Traumatol

View full text Add to dashboard Cite

“…A recent review by Baumbach and colleagues suggests that chronic, nonseptic olecranon or prepatellar bursitis that does not resolve after initial aspiration and corticosteroid injection should be treated with bursectomy [Baumbach et al 2014]. For patients who do not desire to proceed with surgery, the literature offers little further guidance.…”

Section: Introductionmentioning

confidence: 99%

Fibrin glue for olecranon bursitis: a case report

Berkoff

Sandbulte²,

Stafford

et al. 2015

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm

Abstract: The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.

Cited by 108 publications

References 60 publications

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

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

Behandlung der traumatisch eröffneten Bursa olecrani und der chronischen Bursitis olecrani

Fibrin glue for olecranon bursitis: a case report

Contact Info

Product

Resources

About