Surgery for bursitis of the elbow

Introduction

Surgery for bursitis in the elbow is usually not necessary, since the inflammation can often be treated conservatively. However, if the therapy is ineffective or if there is a bacterial infection of the bursa, surgery is often recommended. You will find more detailed information about the operation itself and the follow-up treatment in the course of this article.

Treatment

Bursitis of the elbow, if it is chronic, is initially treated conservatively. For this purpose, it is important to immobilize the affected joint, which can be done by applying a plaster cast if necessary. Above all, a strong pressure load by resting on the elbow should be avoided.

In addition, the administration of painkillers such as ibuprofen or diclofenac and anti-inflammatory drugs is recommended. A puncture of the pus that has accumulated in the bursa in the case of a bacterial infection and also an injection of cortisone for inflammation inhibition can be considered. This therapy should be carried out for 2-3 weeks.

In the absence of improvement or worsening of the inflammation, as well as in cases of bursitis after acute trauma or recurrent inflammation, surgical removal of the bursa is the method of choice. However, the causes of the inflammation and the risk factors, such as occupational stress or anatomical abnormalities such as bony protrusions, which can lead to slight irritation of the bursa, should not be ignored. Before surgery, anticoagulant medication should be discontinued to minimize the risk of bleeding in the surgical site.

It is also important to administer a single dose of antibiotics before the operation to minimize the risk of infection. After opening the skin and the subcutaneous fatty tissue, which is usually very thin at the elbow, the surgeon tries to bluntly detach the bursa and remove it without opening it in order to avoid possible infectious material coming into contact with the surrounding tissue. In the case of peracute inflammation, however, the infection has already spread beyond the bursa.

There is a risk of sepsis (blood poisoning), so this is an urgent indication for surgery. In case of an acute inflammation, which is limited to the bursa, if it cannot be completely removed, it is opened with an incision and rinsed daily. In addition, antibiotic therapy and, if necessary, the installation of a vacuum pump is indicated. This cleans the wound and is connected via suction to a device into which the wound secretion is drained. Once the inflammation has healed, the bursa can be safely removed in a second operation.