Treatment and outcome with traumatic lesions of the olecranon and prepatellar bursa: a literature review apropos a retrospective analysis including 552 cases

Raas, Christoph; Attal, R.; Kaiser, Peter; Popovscaia, Marina; Zegg, Michael

doi:10.1007/s00402-017-2690-2

Cited by 11 publications

(16 citation statements)

References 5 publications

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“…Raas' [31] comparison of 552 olecranon and prepatellar bursitis patients indicated that the median time for an infectious complication to manifest was 6.5 days. As a result, the ideal time to commence treatment is inherently complicated.…”

Section: Discussionmentioning

confidence: 99%

“…Data extracted included: cohort mean age; gender mix; whether septic/aseptic bursitis; severity of bursitis; antibiotics prescribed; presence of immunocompromised patients; timing of follow up; details of the operative procedure; post op management; adjacent treatments administered; and the outcomes of interest. Meric [29], Mathieu [30], and Raas [31] were excluded as we were unable to obtain data on prepatellar bursitis patients separately.…”

Section: Data Extractionmentioning

confidence: 99%

“…Figure 2 outlines our search results. Mathieu [27], Meric [29], and Raas [31] were excluded from the final review as they did not separate cohorts of prepatellar and olecranon bursitis, and we were unable to obtain data on prepatellar bursitis alone from the authors. One stage versus two stage bursectomy, and antibiotic combination outcomes were not included as they each contained data from one source only.…”

Section: Studies and Outcomesmentioning

confidence: 99%

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Management of septic and aseptic prepatellar bursitis: a systematic review

Brown

Smith

Parsons

et al. 2021

Arch Orthop Trauma Surg

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BackgroundDespite contributing to significant morbidity in working age adults, there is no consensus on the optimal treatment for prepatellar bursitis. Much of the existing literature combines prepatellar and olecranon bursitis. This systematic review aims to determine the optimal management of prepatellar bursitis. Study design and methodsA primary search of electronic published and unpublished literature databases from inception to November 2019 was completed. Articles over 25 years old, case reports with less than four patients, paediatric studies, and non-English language papers were excluded. Our primary outcome was recurrence after one year. Comparisons included endoscopic vs open bursectomy, duration of antibiotics. Methodological quality was assessed using the Institute of Health Economics (IHE) and Revised Cochrane Risk of Bias (RoB-2) scoring systems. Meta-analyses were conducted where appropriate. ResultsIn total 10 studies were included (N=702). Endoscopic and open bursectomy showed no difference in recurrence after one year (OR=0.41, 95% CI 0.05-3.53, p=0.67), and surgical complications (OR=1.44, 95% CI 0.34-6.08, p=0.44). 80% endoscopically-treated patients were pain free after one year. Patients treated with antibiotics for less than eight days were not significantly more prone to recurrence (2/17 vs 10/114, OR 0.66, 95% CI 0.13-3.29, p = 0.64) compared to eight days plus at minimum one year post injury. ConclusionsOur study represents the largest cohort of patients evaluating management strategies for prepatellar bursitis, and includes data not previously published. Endoscopic bursectomy is non-inferior to open bursectomy, enabling a shorter hospital stay. It also offers a relatively low risk of post-operative pain. Endoscopic bursectomy is a viable option to treat both septic and aseptic prepatellar bursitis. Our small cohort suggests recurrence and hospital stay are not improved with antibiotic treatment exceeding seven days for septic prepatellar bursitis.

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Section: Discussionmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

Section: Studies and Outcomesmentioning

confidence: 99%

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Management of septic and aseptic prepatellar bursitis: a systematic review

Brown

Smith

Parsons

et al. 2021

Arch Orthop Trauma Surg

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“…Repetitive trauma can cause open wounds that are susceptible to bacterial invasion, thereby leading to septic bursitis [ 7 ]. One study reported that 19.8% of olecranon bursitis cases resulted in a complication such as infection [ 9 ]. While a variety of microbes have been found to produce septic olecranon bursitis, the most common causative agent is Staphylococcus aureus [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Olecranon Bursitis Secondary to Trauma

Subramanian¹,

Stead²,

Mangal³

et al. 2022

Cureus

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“…The most common pathogen for septic complications is Staphylococcus aureus [ 4 ]. With an incidence of 0.2% in trauma patients, the OB is reported to be affected more often (62.1%) than the PB (37.7%) [ 5 ]. There are no evidence-based recommendations for the management of traumatic bursitis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for revision surgery in operative treatment of traumatic injuries of the olecranon and prepatellar bursa

Schöbel¹,

Hantusch²,

Hennings³

et al. 2022

BMC Musculoskelet Disord

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Introduction Traumatic lacerations of the prepatellar (PB) and olecranon bursa (OB) are common injuries. The aim of this study was to gain descriptive data and to identify risk factors associated with complications that made revision surgery after primary bursectomy necessary. Material and methods In this retrospective monocentric study at a level I trauma center, all patients with traumatic lacerations of the PB or OB who were treated with primary surgical bursectomy from 2015 to 2020 were analyzed. Results 150 consecutive patients were included. In 44% of cases, the PB was affected (n = 66), in 56% the OB (n = 84). The reoperation rate after surgical bursectomy was 10.7% (n = 16). The main cause of reoperation was wound infection (50%; n = 8). The most common pathogen of postoperative infections was Staphylococcus aureus (87.5%). Several comorbidities have been identified as risk factors for reoperation after primary surgical bursectomy, such as heart diseases, arterial hypertension, the use of antihypertensives and anticoagulation. In contrast, surgical expertise, use of drains, postoperative immobilization, and postoperative antibiotics had no statistically significant effect. A significantly higher postoperative infection rate (17.6%) was observed in patients who were operated more than 48 h after initial trauma. Conclusions Given the limited recommendations for therapy of these common injuries, further investigations should focus on standardized therapeutic options for lacerations of the PB or OB. Delayed surgical interventions after trauma were associated with higher complication rates. Therefore, urgent surgery within 48 h after trauma may help to prevent revisions. Level of evidence Level of evidence IV.

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Treatment and outcome with traumatic lesions of the olecranon and prepatellar bursa: a literature review apropos a retrospective analysis including 552 cases

Abstract: Traumatic lesions of the OB and PB are associated with a high risk of complications. Prophylactic antibiotic therapy can potentially reduce the risk of infection and the need for revision surgery.

Cited by 11 publications

References 5 publications

Management of septic and aseptic prepatellar bursitis: a systematic review

Management of septic and aseptic prepatellar bursitis: a systematic review

Olecranon Bursitis Secondary to Trauma

Risk factors for revision surgery in operative treatment of traumatic injuries of the olecranon and prepatellar bursa

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