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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

15.03.2021 | Orthopaedic Surgery

Management of septic and aseptic prepatellar bursitis: a systematic review

verfasst von: Oliver S. Brown, T. O. Smith, T. Parsons, M. Benjamin, C. B. Hing

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 10/2022

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Abstract

Background

Despite contributing to significant morbidity in working-age adults, there is no consensus on the optimal treatment for prepatellar bursitis. Much of the existing literature combines prepatellar and olecranon bursitis. This systematic review aims to determine the optimal management of prepatellar bursitis.

Study design and methods

A primary search of electronic published and unpublished literature databases from inception to November 2019 was completed. Articles over 25 years old, case reports with less than four patients, paediatric studies, and non-English language papers were excluded. Our primary outcome was recurrence after 1 year. Comparisons included endoscopic vs open bursectomy, duration of antibiotics. Methodological quality was assessed using the Institute of Health Economics and Revised Cochrane Risk of Bias scoring systems. Meta-analyses were conducted where appropriate.

Results

In total 10 studies were included (N = 702). Endoscopic and open bursectomy showed no difference in recurrence after 1 year (OR 0.41, 95% CI 0.05–3.53, p = 0.67), and surgical complications (OR 1.44, 95% CI 0.34–6.08, p = 0.44). 80% endoscopically-treated patients were pain free after 1 year. Patients treated with antibiotics for less than 8 days were not significantly more prone to recurrence (2/17 vs 10/114, OR 0.66, 95% CI 0.13–3.29, p = 0.64) compared to 8 days plus at minimum 1 year post injury.

Conclusions

Our study represents the largest cohort of patients evaluating management strategies for prepatellar bursitis, and includes data not previously published. Endoscopic bursectomy is non-inferior to open bursectomy, enabling a shorter hospital stay. It also offers a relatively low risk of post-operative pain. Endoscopic bursectomy is a viable option to treat both septic and aseptic prepatellar bursitis. Our small cohort suggests recurrence and hospital stay are not improved with antibiotic treatment exceeding 7 days for septic prepatellar bursitis.

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Titel: Management of septic and aseptic prepatellar bursitis: a systematic review
verfasst von: Oliver S. Brown
T. O. Smith
T. Parsons
M. Benjamin
C. B. Hing
Publikationsdatum: 15.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 10/2022
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-03853-9

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Background

Study design and methods

Results

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