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Simpson JR, Fagerberg A, Toledo R, Joyner PW. No Wound Healing Complications or Recurrences Were Seen and a High Level of Satisfaction Was Reported in Patients Who Underwent Endoscopic Olecranon Bursectomy for Recalcitrant Olecranon Bursitis. Arthrosc Sports Med Rehabil 2024; 6:100832. [PMID: 38299046 PMCID: PMC10827581 DOI: 10.1016/j.asmr.2023.100832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/05/2023] [Indexed: 02/02/2024] Open
Abstract
Purpose To determine the outcomes of endoscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis in one surgeon's practice. Methods A retrospective analysis was conducted on all patients who underwent an endoscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis between January 2018 and May 2021 at one surgeon's practice. Demographic variables as well as causes for olecranon bursitis such as aseptic, septic, and gouty tophi were recorded. In addition, any complications such as infection, recurrence, wound failure, or hospitalizations were documented, with wound dehiscence, recurrence of bursitis, and return to the operating room being the primary outcome measures. During the final phone encounter before finalizing this project, patients were queried to obtain the patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire, quick Disabilities of the Arm Shoulder and Hand score, and the Single Assessment Numeric Evaluation score. Results Our study included 28 patients (23 male and 5 female) with an average age of 68 years (ranging from 33-86 years), all of whom had follow-up. The average follow-up was 24.7 months (range 3-42 months). There were 15 cases (54%) of aseptic bursitis, 13 cases (46%) of septic bursitis, and 7 cases (25%) that 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 intravenous antibiotics, 2 were minor infections treated with oral antibiotics, and one was swelling treated successfully with in-office aspiration. Overall, 24 (86%) patients reported no issues at all related to the surgery. There were no instances of recurrence, wound failure, or secondary operations. Of the 20 (71.4%) patients who were reached for patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire, quick Disabilities of the Arm Shoulder and Hand score, and Single Assessment Numeric Evaluation scores, all 20 patients reported no residual pain or difficulties with daily tasks. Average satisfaction with the procedure was 9.9 of 10 and, on average, patients reported that their elbow functionality was 96% with 100% representing completely normal. Conclusions In this population, patients who underwent endoscopic olecranon bursectomy experienced no recurrences or wound-healing complications necessitating return to the operating room. In addition, patients reported high function and satisfaction after the procedure. Level of Evidence Level IV, therapeutic case series.
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Affiliation(s)
- Jeffrey R. Simpson
- University of Central Florida College of Medicine, Orlando, Florida, U.S.A
| | - Austin Fagerberg
- John P. and Kathrine G. McGovern Medical School at UTHealth, Houston, Texas, U.S.A
| | - Robert Toledo
- University of Central Florida College of Medicine, Orlando, Florida, U.S.A
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Simpson J, Peters C, Knapp T, Joyner PW. Endoscopic Olecranon Bursectomy in the Treatment of Recalcitrant Olecranon Bursitis: Patient Selection and Operative Technique. Arthrosc Tech 2024; 13:102828. [PMID: 38312871 PMCID: PMC10838017 DOI: 10.1016/j.eats.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/03/2023] [Indexed: 02/06/2024] Open
Abstract
Olecranon bursitis is the most common form of bursitis. While it can commonly be treated using noninvasive measures, a surgical approach is indicated for cases of recalcitrant olecranon bursitis, which fail such treatment options. Traditionally, recalcitrant olecranon bursitis has been treated with an open bursectomy. Recently, arthroscopy has been proposed as an alternative method. Contraindications for this approach are cases where the bursa is massively enlarged and contains copious amounts of gouty tophi. While a unanimous consensus regarding which surgical approach is optimal has yet to be made, the endoscopic approach could potentially reduce issues inherent to open bursectomies such as improper wound healing and recurrence. This would reduce patient discomfort and allow them to return to activity sooner. We present a technique for treating recalcitrant olecranon bursitis using endoscopic resection.
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Affiliation(s)
- Jeffrey Simpson
- College of Medicine, University of Central Florida, Orlando, Florida, U.S.A
| | - Cara Peters
- College of Medicine, University of Central Florida, Orlando, Florida, U.S.A
| | - Thomas Knapp
- College of Medicine, University of Central Florida, Orlando, Florida, U.S.A
| | - Patrick W Joyner
- Division of Neuroscience and Spine Associates, Orthocollier, Naples, Florida, U.S.A
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Shota M, Toshiya T, Tomoya I. Septic retrocalcaneal bursitis in a young soccer player treated with hindfoot endoscopic bursectomy: a case report. J Surg Case Rep 2023; 2023:rjad169. [PMID: 37090907 PMCID: PMC10115463 DOI: 10.1093/jscr/rjad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/04/2023] [Indexed: 04/25/2023] Open
Abstract
Septic retrocalcaneal bursitis (RB) is extremely rare with no reports on surgical treatment. Here, we describe a rare case of septic RB in a 14-year-old male soccer player who was treated with hindfoot endoscopic bursectomy. A 14-year-old male soccer player complained of right heel pain without trauma histories when he was playing a soccer. Based on physical examination, radiological findings and laboratory results, we diagnosed the patient with septic RB and started to treat with conservative treatment including a non-weightbearing splint and intravenous antibiotics therapy. However, his symptoms and laboratory results did not improve at 4 days after starting intravenous antibiotics therapy, and so we applied hindfoot endoscopic bursectomy for him. At 4 weeks after the surgery, he could return to the original sport at preinjury level without symptoms and complications. Septic RB in a 14-year-old male soccer player was successfully treated with hindfoot endoscopic bursectomy.
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Affiliation(s)
- Morimoto Shota
- Correspondence address. Department of Orhopaedic Surgery, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, 663-8501 Hyogo, Japan. Tel: +81-798-45-6452; Fax: +81-798-45-6453; E-mail:
| | - Tachibana Toshiya
- Department of Orthopaedic Surgery, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, 663-8501 Hyogo, Japan
| | - Iseki Tomoya
- Department of Orthopaedic Surgery, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, 663-8501 Hyogo, Japan
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Kettering CE, Egro FM, Stofman GM. Olecranon Bursectomy with De-epithelialized Advancement Flap Reconstruction: A Novel Surgical Approach. J Hand Microsurg 2023; 15:156-157. [PMID: 37020604 PMCID: PMC10070001 DOI: 10.1055/s-0040-1716768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Caroline E. Kettering
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Francesco M. Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Guy M. Stofman
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
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Brown OS, Smith TO, Parsons T, Benjamin M, Hing CB. Management of septic and aseptic prepatellar bursitis: a systematic review. Arch Orthop Trauma Surg 2022; 142:2445-2457. [PMID: 33721054 DOI: 10.1007/s00402-021-03853-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite 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 METHODS A 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 1 year. Comparisons included endoscopic vs open bursectomy, duration of antibiotics. Methodological quality was assessed using the Institute of Health Economics and Revised Cochrane Risk of Bias scoring systems. Meta-analyses were conducted where appropriate. RESULTS In total 10 studies were included (N = 702). Endoscopic and open bursectomy showed no difference in recurrence after 1 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 1 year. Patients treated with antibiotics for less than 8 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 8 days plus at minimum 1 year post injury. CONCLUSIONS Our 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 7 days for septic prepatellar bursitis.
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Affiliation(s)
- Oliver S Brown
- St George's University Hospitals NHS Foundation Trust, London, UK. .,Trauma and Orthopaedic Department, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK.
| | - T O Smith
- Oxford University Hospitals, Oxford, UK
| | - T Parsons
- Epsom and St Helier Hospitals, London, UK
| | - M Benjamin
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - C B Hing
- St George's University Hospitals NHS Foundation Trust, London, UK
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Chan YLC, Lui TH. Endoscopic Resection of Chronic Morel-Lavallée Lesion of the Knee. Arthrosc Tech 2021; 10:e1915-e1919. [PMID: 34401233 PMCID: PMC8355186 DOI: 10.1016/j.eats.2021.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/14/2021] [Indexed: 02/03/2023] Open
Abstract
The Morel-Lavallée lesion is a closed internal soft-tissue degloving injury. About 15.7% of Morel-Lavallée lesions occur in the knee region. Morel-Lavallée lesions are considered chronic when the lesion contains a capsule. The capsule prevents resorption of the fluid content, and the lesion will recur when using conservative treatment alone. Surgical debridement with resection of the capsule is a more definitive treatment option, but it may induce wound complications. In this Technical Note, the technical details of endoscopic resection of chronic Morel-Lavallée lesion of the knee are discussed. This minimally invasive technique has the advantage of better cosmetic results and fewer wound complications.
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Affiliation(s)
- Yi Lok Charis Chan
- Department of Orthopaedics and Traumatology, United Christian Hospital, Hong Kong
| | - Tun Hing Lui
- Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, NT, Hong Kong SAR, China,Address correspondence to Dr. T. H. Lui, Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Rd., Sheung Shui, NT, Hong Kong SAR, China.
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Fu QP, Ji H, Liu L, Deng XQ. Mini-invasive treatment with arthroscopic shaver for chronic non-infective prepatellar bursitis. Asian J Surg 2021; 44:928-929. [PMID: 33888368 DOI: 10.1016/j.asjsur.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Qing-Peng Fu
- Xing'an League People's Hospital, 66 Hanshan West Street, Ulanhot, Inner Mongolia, China
| | - Hong Ji
- Xing'an League People's Hospital, 66 Hanshan West Street, Ulanhot, Inner Mongolia, China
| | - Lu Liu
- Xing'an League People's Hospital, 66 Hanshan West Street, Ulanhot, Inner Mongolia, China.
| | - Xiao-Qiang Deng
- Xing'an League People's Hospital, 66 Hanshan West Street, Ulanhot, Inner Mongolia, China.
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Narrative: Review of Anterior Knee Pain Differential Diagnosis (Other than Patellofemoral Pain). Curr Rev Musculoskelet Med 2021; 14:232-238. [PMID: 33818700 DOI: 10.1007/s12178-021-09704-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW This review presents a framework for constructing a differential diagnosis for chronic anterior knee pain associated with overuse other than patellofemoral pain. Traumatic, systemic, and pediatric injuries will not be covered. RECENT FINDINGS From superficial to deep, the anterior knee can be conceptually organized into four layers: (1) soft tissue, (2) extensor mechanism, (3) intracapsular/extrasynovial, and (4) intra-articular. From superficial to deep, diagnoses to consider include bursitis, patellar and quadriceps tendinosis, fat pad impingement, and plica syndromes.
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Abstract
Prepatellar bursitis can be septic and aseptic. Treatment for prepatellar bursitis is determined primarily by the cause of bursitis and secondarily by the pathological change in the bursa. Nonoperative treatment is the mainstay of treatment, and bursectomy is indicated for intractable bursitis resistant to conservative treatment. Open bursectomy has significant risk of surgical site morbidity. In this Technical Note, the technical details of endoscopic resection of prepatellar bursa are presented. This minimally invasive technique has the advantage of better cosmetic results and fewer wound complications.
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Affiliation(s)
- Wing Chung Brian Luk
- Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong SAR, China
| | - Tun Hing Lui
- Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China,Address correspondence to Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.
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Tedesco LJ, Swindell HW, Anderson FL, Jang E, Wong TT, Kazam JK, Kadiyala RK, Popkin CA. Evaluation and Management of Hand, Wrist and Elbow Injuries in Ice Hockey. Open Access J Sports Med 2020; 11:93-103. [PMID: 32425621 PMCID: PMC7196194 DOI: 10.2147/oajsm.s246414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/12/2020] [Indexed: 12/01/2022] Open
Abstract
Ice hockey continues to be a popular, fast-paced, contact sport enjoyed internationally. Due to the physicality of the game, players are at a higher risk of injury. In the 2010 Winter Olympics, men’s ice hockey had the highest injury rate compared to any other sport. In this review, we present a comprehensive analysis of evaluation and management strategies of common hand, wrist, and elbow injuries in ice hockey players. Future reseach focusing on the incidence and outcomes of these hand, wrist and elbow injuries in ice hockey players is warranted.
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Affiliation(s)
- Liana J Tedesco
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Hasani W Swindell
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Forrest L Anderson
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Eugene Jang
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Tony T Wong
- Department of Radiology, New York Presbyterian Hospital, New York, NY, USA
| | - Jonathan K Kazam
- Department of Radiology, New York Presbyterian Hospital, New York, NY, USA
| | - R Kumar Kadiyala
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
| | - Charles A Popkin
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
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