Treatment of olecranon bursitis: a systematic review

Arch Orthop Trauma Surg. 2014 Nov;134(11):1517-36. doi: 10.1007/s00402-014-2088-3. Epub 2014 Sep 19.


Introduction: The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis.

Materials and methods: The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis.

Results: Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis.

Conclusions: Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis.

Level of evidence: Therapeutic IV.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Bursitis / therapy*
  • Combined Modality Therapy
  • Drainage
  • Humans
  • Olecranon Process*
  • Physical Therapy Modalities
  • Postoperative Complications
  • Risk Factors


  • Adrenal Cortex Hormones