# Bursectomy

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{{Short description|Surgical removal of bursae (sacs of synovial fluid in joints)}}
{{use dmy dates|date=May 2026}}
{{Infobox medical intervention
| Name        = Bursectomy
| Image       =
| Caption     =
| ICD10       =
| ICD9        = 83.5
| MeshID      =
| OtherCodes  =
}}

A '''bursectomy''' is the removal of a [bursa](/source/synovial_bursa), which is a small sac filled with [synovial fluid](/source/synovial_fluid) (a lubricating liquid found in joints) that cushions adjacent bone structures and reduces friction in joint movement. This procedure is usually carried out to relieve [chronic inflammation](/source/chronic_inflammation) ([bursitis](/source/bursitis)) and [infection](/source/infection) when conservative management has failed to improve patient outcomes.<ref name="Mitchell et al. 2016"/>

Because most clinically significant bursae are [subcutaneous](/source/Subcutaneous_tissue), the procedure is performed most often at the [olecranon](/source/olecranon), [prepatellar](/source/Prepatellar_bursa), [subacromial](/source/subacromial_bursa), [trochanteric](/source/Greater_trochanteric_pain_syndrome), and [scapulothoracic](/source/scapulothoracic) sites, although any bursa in the [appendicular skeleton](/source/appendicular_skeleton) can be removed if symptoms warrant.<ref name="Azar et al. 2021"/> Textbook guidelines advise that surgery be deferred until active infection [sepsis](/source/sepsis) has been controlled with appropriate [antibiotic](/source/antibiotic)s or until at least three months of non-operative management have failed in aseptic bursitis.<ref name="Azar et al. 2021"/><ref name="Nchinda & Wolf 2021"/>

The classical operation is an open bursectomy conducted through a longitudinal or transverse [incision](/source/Surgical_incision) directly over the affected sac, permitting removal of the bursa's outer layer ([capsulectomy](/source/capsulectomy)), scraping away of inflamed tissue ([curettage](/source/curettage)) and, where necessary, excision of associated [osteophyte](/source/osteophyte)s or [spur](/source/spur)s.<ref name="Azar et al. 2021"/> [Minimally invasive](/source/Minimally_invasive_procedure) techniques have been developed in parallel: [arthroscopic](/source/arthroscopy) subacromial bursectomy, [endoscopic](/source/endoscopy) olecranon bursectomy and endoscopic trochanteric bursectomy use small portals to [resect](/source/Surgery) the bursa under visual control while preserving overlying skin and reducing [postoperative wound](/source/Postoperative_wounds) problems.<ref name="Crutchfield et al. 2021"/><ref name="Nchinda & Wolf 2021"/>

A 2021 [systematic review](/source/systematic_review) comparing 502 hips treated for recalcitrant trochanteric bursitis reported no significant differences in pain relief, functional scores or complication rates between open and arthroscopic approaches, with overall patient-satisfaction levels of 82–95&nbsp;percent.<ref name="Crutchfield et al. 2021"/> [Complications](/source/Complication_(medicine)) are uncommon but include wound breakdown, superficial infection, [seroma](/source/seroma), recurrence of bursal fluid and, rarely, nerve irritation. Combined study data show complication rates varying from 0–33&nbsp;percent across different studies, with actual surgical failures occurring in fewer than 8 percent of cases.<ref name="Crutchfield et al. 2021"/><ref name="Nchinda & Wolf 2021"/>

Post-operative protocols typically immobilise the limb in a [splint](/source/Splint_(medicine)) or [compression dressing](/source/Bandage) for 7–14&nbsp;days to allow dermal adherence, followed by graduated [physiotherapy](/source/physiotherapy) aimed at restoring range of motion while avoiding direct pressure over the excision site.<ref name="Azar et al. 2021"/><ref name="Nchinda & Wolf 2021"/>

Most patients regain unrestricted daily activities within six to eight weeks, and the bursa reforms as a thin, non-inflamed sac that rarely becomes symptomatic if the underlying mechanical causes (e.g., repetitive kneeling or leaning) are addressed.<ref name="Azar et al. 2021"/>
Current reviews emphasise that bursectomy should be presented as a supplementary option for select cases rather than a routine first-line intervention, balancing its high success rate against the generally lower [morbidity](/source/morbidity) of continued conservative care.<ref name="Crutchfield et al. 2021"/><ref name="Nchinda & Wolf 2021"/>

==See also==
* [List of surgical procedures](/source/List_of_surgical_procedures)

==References==
{{reflist|25em|refs=
<ref name="Azar et al. 2021">
{{cite book
 |last1=Azar |first1=Frederick M.
 |last2=Canale |first2=S. Terry
 |last3=Beaty |first3=James H.
 |year=2021
 |title=Campbell's Operative Orthopaedics |edition=14th
 |publisher=Elsevier
 |isbn=978-0-323-67217-7
}}
</ref>

<ref name="Crutchfield et al. 2021">
{{cite journal
 |last1=Crutchfield |first1=Connor R.
 |last2=Padaki      |first2=Ajay S.
 |last3=Holuba      |first3=Kurt S.
 |year=2021
 |title=Open versus arthroscopic surgical management for recalcitrant trochanteric bursitis: A systematic review
 |journal=[Iowa Orthopaedic Journal](/source/Iowa_Orthopaedic_Journal)
 |volume=41 |issue=2 |pages=45–57
 |pmid=34924870 |pmc=8662929
}}
</ref>

<ref name="Mitchell et al. 2016">
{{cite journal
 |last1=Mitchell |first1=Justin J.          |last2=Chahla    |first2=Jorge
 |last3=Vap      |first3=Alexander R.       |last4=Menge     |first4=Travis J.
 |last5=Soares   |first5=Eduardo            |last6=Frank     |first6=Jonathan M.
 |last7=Dean     |first7=Chase S.           |last8=Philippon |first8=Marc J.
 |display-authors=6
 |year=2016
 |title=Endoscopic trochanteric bursectomy and iliotibial band release for persistent trochanteric bursitis
 |journal=[Arthroscopy Techniques](/source/Arthroscopy_Techniques)
 |volume=5 |issue=5 |pages=e1185–e1189
 |pmid=28224075 |pmc=5310191
 |doi=10.1016/j.eats.2016.07.005 |doi-access=free
}}
</ref>

<ref name="Nchinda & Wolf 2021">
{{cite journal
 |last1=Nchinda |first1=Nzuekoh N.
 |last2=Wolf |first2=Jennifer M.
 |year=2021
 |title=Clinical management of olecranon bursitis: A review
 |journal=[Journal of Hand Surgery (American Volume)](/source/Journal_of_Hand_Surgery_(American_Volume))
 |volume=46 |issue=6 |pages=501–506
 |pmid=33840568 |doi=10.1016/j.jhsa.2021.02.006
}}
</ref>

}} <!-- end "refs=" -->

{{Muscle/soft tissue procedures}}

Category:Orthopedic surgical procedures
Category:Synovial bursae

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Adapted from the Wikipedia article [Bursectomy](https://en.wikipedia.org/wiki/Bursectomy) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Bursectomy?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.