Bursectomy

(Removal of Bursa)

Definition

A bursectomy is a surgical procedure to remove 1 or more bursas. The bursas are fluid-filled sacs near a joint that help the joint work smoothly.

The most common joints affected are the shoulder, elbow, knee, and hip.

Reasons for Procedure    TOP

The bursa helps soft tissue like muscle and tendons move smoothly over bony areas of the joint. A bursa can be damaged by irritation, overuse, injury, or infection which can make basic movement painful. The pain can interfere with everyday activities.

Most bursa injuries will improve with conservative treatment like temporarily changing certain activities, medication, and physical therapy. If conservative treatment is unsuccessful or the problem keeps recurring a bursectomy may be recommended.

Bursitis in the Shoulder

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Possible Complications     TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Excess bleeding
  • Infection
  • Blood clots
  • Blood vessel or nerve damage
  • Instrument breakage (rare)

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

  • Smoking
  • Drinking
  • Chronic diseases, such as diabetes or obesity

What to Expect    TOP

Prior to Procedure

The doctor will thoroughly examine the affected joint. Tests may include:

Before the procedure:

  • Talk to your doctor about any medications, herbs, or supplements you are taking. You may need to stop taking some medications up to a week before the procedure.
  • Arrange for a ride home.
  • You may be asked to stop foods and drinks the night before the procedure.

Anesthesia

The type of anesthesia used depends on the affected joint and extent of the procedure. Anesthesia may be:

  • General—You will be asleep.
  • Local—The area will be numbed.
  • Spinal—A specific area of the body is numbed with medication placed in the back.

Description of the Procedure     TOP

A bursectomy is done with a procedure called arthroscopy. Small, buttonhole-sized incisions are made by the joint. A small tube-like device called an arthroscope is inserted into the holes. The scope has a light and camera that allows the doctor to see the bursa.

Specialized surgical instruments are placed through other incisions and passed to the area. The instruments can detach bursa from local tissue and remove the bursa and any scar tissue.

After the arthroscope is removed from the joint, the holes will be stitched closed. A compression bandage will be applied over the dressing to control swelling and prevent blood clots. If appropriate a brace or sling will be placed to help support the joint.

How Long Will It Take?    TOP

The procedure may be 30 minutes to up to 2 hours. The length of the procedure will depend on the location of the bursa.

Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. There will be some discomfort after surgery as the area heals. Discomfort after the procedure can be managed with medications.

Post-procedure Care     TOP

At the Care Center

Right after the procedure, the staff will monitor your breathing, heart rate, and blood pressure. An ice pack will be applied to help control swelling at the joint.

Before you leave, the staff will teach you how to use any recommended braces or assisted devices.

At Home

It will take a few days for the incisions to heal but complete joint recovery takes several weeks. Movement of the joint may be restricted in the first few weeks. You will gradually be able to return to normal activity levels. You will also be given exercises and movements to help your joint help properly.

Call Your Doctor    TOP

Call your doctor if any of these occur:

  • Signs of infection, including fever or chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision
  • Persistent nausea or vomiting
  • Pain that cannot be controlled with the medications you were given
  • Numbness or weakness in the affected joint or muscles
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Arthroscopy Association of North America
http://www.aana.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

The Canadian Orthopaedic Association
http://www.coa-aco.org
When it Hurts to Move—Canadian Orthopaedic Foundation
http://whenithurtstomove.org

References:

Arthroscopy. American Association of Orthopaedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated May 2010. Accessed April 20, 2016.
Bursectomy. Cooper University Health Care website. Available at:
...(Click grey area to select URL)
Accessed April 20, 2016.
Bursitis. Johns Hopkins Medicine website. Available at:
...(Click grey area to select URL)
Accessed April 20, 2016.
Olecranon bursa excision. Sussex Hand Surgery website. Available at:
...(Click grey area to select URL)
Accessed April 20, 2016.
Last reviewed May 2016 by Warren Bodine, DO

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