Bursectomy: A Complete Guide to Surgery, Recovery & Alternatives

What is a Bursectomy? (Introduction & Overview)

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. Bursae reduce friction during movement, but when they become irritated (a condition called bursitis), they can cause severe pain, swelling, and limited mobility.

This surgery is typically recommended when conservative treatments like rest, ice, physical therapy, or corticosteroid injections fail to relieve symptoms. Common joints where bursectomy is performed include the shoulder (subacromial bursa), elbow (olecranon bursa), hip (trochanteric bursa), and knee (prepatellar bursa).

Bursectomy can be performed as an open surgery (with a larger incision) or arthroscopically (minimally invasive with small incisions and a camera). The goal is to remove the damaged bursa, allowing the joint to move smoothly again.

Why is a Bursectomy Needed? (Indications & Causes)

A bursectomy becomes necessary when chronic bursitis significantly impacts daily life and doesn’t respond to non-surgical treatments. Here are the most common reasons:

• Chronic Bursitis: Repetitive motions (e.g., kneeling, throwing) or prolonged pressure (e.g., leaning on elbows) can cause persistent inflammation.
• Infected Bursa (Septic Bursitis): Bacterial infections may require surgical drainage and removal.
• Calcified Bursa: Calcium deposits within the bursa can cause chronic pain.
• Recurrent Bursitis: Some patients experience repeated flare-ups despite conservative care.
• Trauma or Injury: Direct impact can damage the bursa, leading to chronic swelling.

Conditions like rheumatoid arthritis, gout, or diabetes can increase the risk of bursitis. If pain limits mobility or sleep, or if antibiotics/steroids don’t help, a bursectomy may be the next step.

Types of Bursectomy Procedures (Surgical & Minimally Invasive Options)

Depending on the severity and location of bursitis, surgeons may recommend one of these approaches:

1. Open Bursectomy: A traditional method where a surgeon makes a single, larger incision to remove the bursa. Used for severe cases or infected bursae.
2. Arthroscopic Bursectomy: A minimally invasive technique using tiny incisions, a camera (arthroscope), and specialized tools. Benefits include faster recovery and less scarring.
3. Ultrasound-Guided Bursectomy: For precision, some surgeons use ultrasound imaging to locate and drain the bursa before removal.

Arthroscopic surgery is preferred for joints like the shoulder or knee, while open surgery may be needed for complex cases. The choice depends on the patient’s health, bursa condition, and surgeon’s expertise.

Preparing for a Bursectomy (Pre-Surgery Steps & Tests)

Proper preparation ensures a smooth surgery and recovery. Here’s what to expect:

• Medical Evaluation: Blood tests, imaging (X-ray, MRI), and a physical exam to assess joint health.
• Medication Adjustments: Stop blood thinners (e.g., aspirin) or anti-inflammatory drugs as advised.
• Fasting: No food or drink 8–12 hours before surgery if general anesthesia is used.
• Arrangements: Plan for someone to drive you home post-surgery and assist with daily tasks.

Discuss allergies, smoking habits (smoking delays healing), and any infections with your surgeon. Pre-surgery physical therapy may also be recommended to strengthen the joint.

What Happens During the Surgery? (Step-by-Step Procedure)

A bursectomy typically follows these steps:

1. Anesthesia: Local, regional, or general anesthesia is administered for comfort.
2. Incision: For open surgery, a 2–3 inch cut is made. For arthroscopy, 2–3 tiny incisions.
3. Bursa Removal: The surgeon drains fluid, removes the inflamed bursa, and checks surrounding tissues.
4. Closure: Incisions are stitched, and a sterile bandage is applied.

The surgery usually takes 30–60 minutes, depending on complexity. Patients can often go home the same day unless complications arise.

Recovery After Bursectomy (Post-Op Care & Healing Timeline)

Recovery varies by procedure type but generally follows this timeline:

• First 48 Hours: Rest, ice the area, and keep it elevated to reduce swelling.
• 1–2 Weeks: Light activities resume, but avoid strenuous movements. Use pain meds as prescribed.
• 3–6 Weeks: Physical therapy begins to restore strength and flexibility.
• 6+ Weeks: Full recovery for minimally invasive procedures; open surgery may take longer.

Follow your surgeon’s instructions on wound care, exercises, and follow-up visits. Most patients regain full joint function within 2–3 months.

Risks and Complications (Potential Side Effects)

While bursectomy is generally safe, possible risks include:

• Infection: Rare but possible at the incision site.
• Bleeding or Blood Clots: More common in open surgeries.
• Nerve Damage: Temporary numbness near the joint.
• Recurrence: A new bursa may form, but it’s usually pain-free.

Contact your doctor if you notice fever, excessive swelling, or worsening pain—these could signal complications.

Alternatives to Bursectomy (Non-Surgical Treatments)

Surgery is a last resort. Try these options first:

• Rest & Ice: Avoid aggravating activities and apply ice packs.
• Medications: NSAIDs (e.g., ibuprofen) or corticosteroid injections to reduce inflammation.
• Physical Therapy: Stretching and strengthening exercises.
• Aspiration: Draining fluid with a needle (for infected bursae).

If symptoms persist after 6–12 months of conservative care, surgery may be considered.

FAQs About Bursectomy (Common Patient Questions)