Azad YILDIRIM, Şehmus YİĞİT, Yılmaz MERTSOY, Mehmet Akif ÇAÇAN, Ahmet KAPUKAYA

Non-Septik bursitlerin endoskopik cerrahi ile tedavisi

Amaç: Amacımız, nonseptik bursitlerde endoskopik cerrahinin yara problemleri, hareket açıklıkları ve işe erken dönüş açısından çok önemli faydalar sağladığını gösteren kabul edilebilir bir işlem olduğunu göstermektir.Yöntemler: Bu çalışmaya 2008-2012 yılları arasında medikal tedaviye yanıt vermemiş tekrarlayan minör travmalarla oluşmuş nonseptik bursitisli hastalar alındı. Tanı için tüm hastalarda; AP ve yan grafiler, ultrasound, sıvının mikro ve makroskopik analizleri ve aerobik ve anaerobik kültürler çalışıldı. Bulgular: Yaş ortalamaları 40,8 yıl ve takip süresi 2,6[25] yıl olan ikisi diz travması ve diğerleri repetitif minör travmalarla oluşan 15 prepatellar 13 olekranon ve 4 ayak bileği bursitinde; endoskopik cerrahi sonrası yara skarı, duyu kaybı ve enfeksiyon gibi komplikasyonlar olmadı. Medikal tedaviye yanıt veren 1 adet nüks görüldü.Sonuç: Endoskopik bursektomi kısa ameliyat ve işe dönme süresi, minimal yara problemleri ve mükemmel sonuçlar nedeniyle güvenilir ve uygulanabilir bir işlemdir

Treatment of nonseptic bursitis with endoscopic surgery

Objective: The aim of this study was to show that endoscopic surgery is a simple and acceptable method for various problems associated with wounds, range of motion and that such surgery ensures an early return to work after treatment of nonresponding nonseptic bursitis. Methods: Thirty-two patients with nonseptic bursitis caused by repeated minor trauma that did not respond to medical treatment from 2008 to 2012 were included in this study. Radiographic [anteroposterior and lateral], ultrasound, macro and microscopic analyses of drainage liquid and aerobic and anaerobic cultures were obtained from the patients for the diagnosis.Results: The mean age was 40.8 years. Fifteen patients had prepatellar bursitis, 13 had olecranon bursitis and 4 had ankle bursitis. Two patients had a history of falling on their knee. The other patients had a history of repetitive stimulation .The mean follow up period was 2.6 years [range. 2-5 years] and no medical complications occurred after the endoscopic surgery; such as scarring, loss of sensation and infection. One recurrence in response to medical treatment was observed.Conclusion: Endoscopic bursectomy is a short and acceptable procedure with excellent results in terms of returning to work early and minimal wound related problems.

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Crenshaw AH. Campbells's operative orthopaedics. St Louis: Mosby; 1992.
Ogilvie Harris DJ, Gilbart M. Endoscopic bursal resection: the olecranon bursa and prepatellar bursa. Arthroscopy 2000;16:249-253.
Kerr DR. Prepatellar and olecranon arthroscopic bursectomy. Clin Sports Med. 1993;12:137-142.
Donahue F, Turkel D, Mnaymneh W, Ghandur Mnaymneh L. Hemorrhagic prepatellar bursitis. Skeletal Radiol 1996;25:298-301.
Garcia Porrua C, Gonzalez Gay MA, Ibanez D, Garcia Pais MJ. The clinical spectrum of severe septic bursitis in northwestern Spain: a 10 year study. J Rheumatol 1999;26:663-667.
Gomez Rodriguez N, Mendez Garcia MJ, Ferreiro Seoane JL, Ibanez Ruan J, Penelas-Cortes Bellas Y. [Infectious bursitis: study of 40 cases in the prepatellar and olecranon regions]. Enferm Infecc Microbiol Clín 1997;15:237-242.
Papadakis KA, Vartivarian SE, Vassilaki ME, Anaissie EJ. Septic prepatellar bursitis caused by Stenotrophomonas (Xanthomonas) maltophilia. Clin Infect Dis 1996;22:388-389.
McAfee JH, Smith DL. Olecranon and prepatellar bursitis. Diagnosis and treatment. West J Med 1988;149:607-610.
Quayle JB, Robinson MP. A useful procedures in the treatment of chronic olecranon bursitis. Injury. 1978;9:299-302.
Quayle JB, Robinson MP. An operation for chronic prepatellar bursitis. J Bone Joint Surg (Br)1976;58:504- 506.
Nussbaumer P, Candrian C, Hollinger A. [Endoscopic bursa shaving in acute bursitis]. Swiss Surg 2001;7:121-125.
Steinacker T, Verdonck A. [Endoscopic therapy Sportschaden 1998;12:162-164. bursitis]. Sportverletz
Stell IM. Management of acute bursitis: outcome study of a structured approach. J R Soc Med 1999;92:516- 521.
Freys SM. [Olecranon and prepatellar bursitis]. Langen- becks Arch Chir Suppl Kongressbd1997;114:493-496.
Pien FD, Ching D, Kim E. Septic bursitis: experience in a community practice. Orthopaedics 1991;14:981- 984.
Witonski D. [Arthroscopic resection of bursitis changes in the prepatellar bursae-preliminary report]. Chir Narzadov Ruchu Ortopedia Polska 1997;62:63-65.
Huang YC, Yeh WL. Endoscopic treatment of prepatellar bursitis. Int Orthop 2011;35:355-358.
Kaalund S, Breddam M, Kristensen G. Endoscopic resection of the septic prepatellar bursa. Arthroscopy 1998;14:757-758.