Bursectomy: Surgical Removal of an Inflamed Bursa

Introduction to Bursectomy

A bursectomy is a surgical procedure to remove an inflamed or infected bursa, a small fluid-filled sac that cushions bones, tendons, and muscles near joints. When conservative treatments like rest, ice, or medications fail to relieve chronic bursitis (bursa inflammation), a bursectomy may be recommended. This procedure helps restore pain-free joint movement, particularly in areas like the shoulder, elbow, hip, or knee. While minimally invasive techniques (arthroscopic bursectomy) are often preferred, open surgery may be needed in severe cases. Understanding what to expect before, during, and after the procedure can help patients prepare for a smooth recovery and optimal outcomes.

What is a Bursa and Why Does It Get Inflamed?

Bursae are thin, slippery sacs filled with synovial fluid that reduce friction between bones and soft tissues in joints. The human body has over 150 bursae, commonly found in the shoulders, elbows, hips, and knees. When a bursa becomes inflamed (bursitis), it swells, causing pain, stiffness, and limited mobility. Common causes include repetitive motions (e.g., throwing, kneeling), joint overuse, trauma, infections (septic bursitis), or conditions like rheumatoid arthritis. Chronic inflammation can thicken the bursa, making it non-functional. In such cases, removing the damaged bursa (bursectomy) may be the best solution to relieve pain and restore joint function.

When is a Bursectomy Needed? (Indications)

A bursectomy is typically considered when non-surgical treatments—such as anti-inflammatory medications, corticosteroid injections, physical therapy, or aspiration—fail to provide lasting relief. Doctors may recommend surgery for chronic bursitis that persists for months, recurrent infections (septic bursitis), or when calcium deposits or scar tissue severely restrict joint movement. It’s also advised if imaging (MRI or ultrasound) shows significant bursa thickening or damage. Patients with conditions like rheumatoid arthritis or gout may develop stubborn bursitis requiring surgical intervention. Ultimately, the decision depends on symptom severity, the patient’s lifestyle, and whether conservative measures have been exhausted.

Types of Bursectomy Procedures

Bursectomies can be performed using different techniques, depending on the affected joint and severity of inflammation:

Preparing for Bursectomy Surgery

Proper preparation ensures a smoother surgery and recovery. Your surgeon will conduct a pre-operative evaluation, including blood tests, imaging, and a review of medications (e.g., stopping blood thinners). For septic bursitis, antibiotics may be prescribed beforehand. Patients should arrange for transportation post-surgery (if outpatient) and plan for at-home recovery aids (ice packs, cushions, or mobility supports). Fasting is required 8–12 hours before the procedure. Wear loose clothing on surgery day, and discuss anesthesia options (local, regional, or general). Mental preparation is equally important—ask questions about expected outcomes, rehabilitation, and potential limitations during healing.

Step-by-Step Procedure: How Bursectomy is Performed

Here’s what typically happens during a bursectomy:

  1. Anesthesia: Administered to ensure comfort (local for small bursae; general for larger/joint procedures).
  2. Incision: For arthroscopy, 2–3 tiny cuts are made; open surgery requires a single larger incision.
  3. Bursa Removal: The surgeon carefully excises the inflamed bursa, preserving surrounding tissues.
  4. Debridement (if needed): Calcium deposits or infected tissue may be cleaned out.
  5. Closure: Incisions are closed with sutures or steri-strips, followed by a sterile bandage.

The surgery usually takes 30–60 minutes, depending on complexity. Most patients go home the same day.

Recovery and Post-Operative Care

Recovery varies by procedure type but generally follows these stages:

Follow-up appointments ensure proper healing. Adhering to your surgeon’s guidelines minimizes complications.

Risks and Complications of Bursectomy

While generally safe, bursectomy carries potential risks, including:

Choosing an experienced surgeon reduces these risks significantly.

FAQs About Bursectomy

1. Is bursectomy a major surgery?

Most bursectomies are minor, outpatient procedures. Arthroscopic techniques involve minimal downtime, while open surgeries may require a longer recovery.

2. Will my joint function normally after bursa removal?

Yes. The body often forms a new bursa over time. Physical therapy helps maintain joint mobility post-surgery.

3. How long until I can return to work/sports?

Desk jobs may resume in 1–2 weeks; strenuous activities/sports may take 4–6 weeks or longer, depending on healing progress.

4. Can bursitis come back after surgery?

Recurrence is rare if post-op care and activity modifications (e.g., ergonomic adjustments) are followed.