This protocol addresses patients with olecranon bursitis in whom an initial aspiration of bursal fluid was performed but failed to achieve resolution of swelling within approximately three weeks.
Aspiration of olecranon bursa fluid was carried out as the first-line intervention. The target goal — resolution of olecranon bursal swelling within approximately three weeks — was not achieved, indicating the need for escalation to a further treatment step.
The escalated approach combines aspiration with an intrabursal corticosteroid injection — a targeted anti-inflammatory intervention directed at the olecranon bursa. The full protocol specifies the agents, procedural details, and sequencing.
A measurable decrease in olecranon bursal swelling is expected at one week, with full resolution of bursitis anticipated at approximately two to three weeks.
DOI: 10.1016/j.jhsa.2021.02.006
Given the inflammatory pathology of nonseptic olecranon bursitis, anti-inflammatory treatment with intrabursal corticosteroid injection has been proposed for localized treatment.
The 25 patients treated with injection of 20 mg triamcinolone hexacetonide had a markedly faster reduction in bursal effusion.
Administration of intrabursal methylprednisolone acetate with oral naproxen resulted in the largest decrease in swelling at 1 week followed by sustained improvement of the condition at 3 weeks.
Kim et al reported that aspiration with steroid injection was associated with significantly faster resolution of bursitis at an average of 2.3 weeks compared with compression with NSAIDs and aspiration-alone treatment groups.
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