Prepatellar and olecranon arthroscopic bursectomy.
ABSTRACT Arthroscopic resection of prepatellar and olecranon bursae is a technically feasible operation. It is not more difficult than removing synovium from the suprapatellar pouch of the knee. Although there have been complications, this procedure appears to avoid the problems about the wound described with the open excisional operations for chronic olecranon and prepatellar bursitis.
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ABSTRACT: BACKGROUND: Although traumatic lacerations of the olecranon (OB) and praepatellar bursae (PB) are common entities often associated with complications, no study could be found on this injury. The aim of this study was to survey the current treatment concepts for acute traumatic laceration of the OB and PB in Germany, Austria and Switzerland. MATERIALS AND METHODS: An international online survey was conducted among orthopaedic and trauma surgeons in Germany (TraumaNetwork DGU), Austria (Austrian Society of Trauma (ÖGU) and Orthopaedic (ÖGO) Surgeons) and Switzerland (Swiss Orthopaedic Surgeons and Swiss Society of Infectious Disease (CH)) (n=1967). The survey comprised of five demographical questions, the current treatment concepts were evaluated using a case study. RESULTS: The overall-response-rate was 16% (12-46%). 88% of the responding physicians were male, aged 47.5±10.2 years with a mean working experience of 20.1±10.6 years. 54% of the surveyed physicians were either senior or chief physicians. Treatment concepts varied significantly between DGU and ÖGO/CH (p=0.02/p=0.006), no significant differences could be found between DGU and ÖGU. Generally, German and Austrian trauma surgeons favoured bursectomy (86.7%/90.9%) and immobilisation (68.3%/77.3%). Austrian orthopaedic surgeons performed fewer bursectomies (69.3%) but had the highest proportion for administering antibiotics (73.9%). Less than 50% of Swiss physicians indicated bursectomy as a treatment option. CONCLUSION: Overall, this survey revealed a significant heterogeneity in treatment approaches in Central Europe. Further evidence is needed to identify the best treatment concepts for traumatic lacerations of the OB and PB.Injury 09/2012; · 2.46 Impact Factor
- British Journal of Medicine & Medical Research. 01/2014; 4(1):272-278.
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ABSTRACT: Olecranon bursitis and prepatellar bursitis are common entities, with a minimum annual incidence of 10/100,000, predominantly affecting male patients (80 %) aged 40-60 years. Approximately 1/3 of cases are septic (SB) and 2/3 of cases are non-septic (NSB), with substantial variations in treatment regimens internationally. The aim of the study was the development of a literature review-based treatment algorithm for prepatellar and olecranon bursitis. Following a systematic review of Pubmed, the Cochrane Library, textbooks of emergency medicine and surgery, and a manual reference search, 52 relevant papers were identified. The initial differentiation between SB and NSB was based on clinical presentation, bursal aspirate, and blood sampling analysis. Physical findings suggesting SB were fever >37.8 °C, prebursal temperature difference greater 2.2 °C, and skin lesions. Relevant findings for bursal aspirate were purulent aspirate, fluid-to-serum glucose ratio <50 %, white cell count >3,000 cells/μl, polymorphonuclear cells >50 %, positive Gram staining, and positive culture. General treatment measures for SB and NSB consist of bursal aspiration, NSAIDs, and PRICE. For patients with confirmed NSB and high athletic or occupational demands, intrabursal steroid injection may be performed. In the case of SB, antibiotic therapy should be initiated. Surgical treatment, i.e., incision, drainage, or bursectomy, should be restricted to severe, refractory, or chronic/recurrent cases. The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.Archives of Orthopaedic and Trauma Surgery 12/2013; · 1.36 Impact Factor