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Treatment of olecranon bursitis: a systematic review

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis.

Materials and Methods

The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis.

Results

Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis.

Conclusions

Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis.

Level of evidence

Therapeutic IV.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Columbia University Medical Center, 630 West 168th Street, New York, 10032-3784, NY, USA

    Eli T. Sayegh

  2. Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th Street, PH11-1119, New York, 10032-3784, NY, USA

    Robert J. Strauch

Authors
  1. Eli T. Sayegh
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  2. Robert J. Strauch
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Corresponding author

Correspondence to Robert J. Strauch.

Appendix

Appendix

See Appendix Tables 3, 4, 5, 6.

Table 3 Patient characteristics of included studies
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Table 4 Treatment algorithm in included studies
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Table 5 Outcomes in included studies
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Table 6 Complications in included studies
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Sayegh, E.T., Strauch, R.J. Treatment of olecranon bursitis: a systematic review. Arch Orthop Trauma Surg 134, 1517–1536 (2014). https://doi.org/10.1007/s00402-014-2088-3

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  • DOI: https://doi.org/10.1007/s00402-014-2088-3

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