Synonym
medical: Bursitis
Definition
There are bursa sacs in many parts of the body. They serve to “cushion” bone protrusions, and inflammation occurs mainly as a result of injuries or mechanical overstrain. Depending on their origin, bursitis is first treated conservatively, rarely by surgery.
Aseptic inflammation, i.e. inflammation in which no bacteria have entered and which complicates the inflammation, is usually treated conservatively by cooling, sparing and anti-inflammatory medication (anti-inflammatory drugs). If there is no improvement, this is usually an indication for surgical therapy. Septic bursitis, i.e. those in which there is also an infection, must also be partially treated surgically, as there is a risk of the infectious agents spreading in the body, which in the worst case can lead to sepsis.
Septic inflammation usually occurs in the context of injuries, as the bacteria have the opportunity to penetrate deeper into the tissue by destroying the skin barrier. Nowadays, however, non-surgical treatment using antibiotics is increasingly being sought even for septic bursitis. The aim of the operation is usually a complete removal of the bursa, the so-called bursectomy.
The disadvantage of this variant is that open surgery is required, which means that a sufficiently large skin incision must be made, which on the one hand leads to scarring and on the other hand can lead to functional limitations in the area of a joint – although this is rather rare. Another type of surgery is bursoscopy, in which instruments are inserted into the bursa through very small skin incisions under visual control, with the help of which the inflamed inner lining (synovial mucosa) of the bursa is carefully removed. This procedure is used particularly in chronic inflammatory processes, and is still used much less frequently than bursectomy.
When operating on a bursa, there are the typical surgical risks such as the risk of bleeding and nerve lesions and thus (usually temporary) sensitivity limitations in the surgical area. There is also – as with any operation – a risk of infection from pathogens that can penetrate the wound during the operation. Surgical removal of the bursa usually results in a complete regression of the symptoms.
