Bursectomy is a surgical procedure to remove a small, fluid-filled sac (bursa) within a joint when it becomes inflamed (bursitis). The bursa act as cushions for bones, and the muscles and tendons which are located near them.
Inflammation is more likely to develop in joints that perform repetitive motions. Most commonly, the hips, elbows, or shoulder joints are affected; however inflammation may also develop in the knee, heel, or big toe.
Understanding the procedure
A bursectomy is a fairly simple and minimally invasive procedure that is typically done arthroscopically on an outpatient basis, meaning no overnight stay in the hospital. In this technique, the bursa is removed through a small incision or cut over the joint. A tiny camera, or arthroscope, is placed in the incision so the doctor can guide the surgical instruments and cut out the bursa. Because this surgery is much less invasive, recovery is quicker and less painful.
Indications for the procedure
People who experience severe or chronic problems that restrict movement or certain activities would benefit most from a bursectomy.
While each case is unique, there are common indications that may warrant the consideration of a bursectomy:
Chronic Bursitis: Individuals experiencing persistent inflammation of a bursa, known as chronic bursitis, often seek a bursectomy for the long-term management of their symptoms.
Limited Range of Motion: A restricted range of motion in a joint due to bursitis or other related conditions may prompt a recommendation for a bursectomy. A primary objective of a bursectomy is to ease the physical impairments caused by an inflamed or enlarged bursae.
Failed Conservative Treatments: The most common treatment for the bursa is rest and anti-inflammatory medication. This treatment usually resolves most problem conditions. When alternative approaches such as medications and physical therapy no longer treat symptoms effectively, a bursectomy may be your best option for sustained relief.
Benefits of Bursectomy for Qualifying Individuals
There are many unique benefits to a bursectomy for those that have sought other treatment options and found that a procedure may be the best choice for them.
Pain Relief: One of the primary benefits of a bursectomy is the potential for significant relief of symptoms, most notably pain. By removing the inflamed or damaged bursa, the source of pain is addressed directly, allowing individuals to experience immediate relief.
Restored Function: Individuals with restricted movement due to bursitis-related issues can benefit from restoration of physical functionality. The procedure aims to improve joint mobility, enabling patients to participate in more activities than they were previously able.
Enhanced Quality of Life: For those who feel bursitis has significantly affected their lives on a daily basis, a bursectomy can contribute to an improved overall quality of life. This can include daily tasks around the house, the ability to accomplish their work effectively, and more physical recreation activities.
Prevention of Recurrent Issues: Many patients consistently return to medication to relieve their symptoms, only to find that their symptoms return. By removing the problematic bursa, the likelihood of recurrence is reduced, providing patients with more sustainable and long-term improvement.
The Risks of a Bursectomy Procedure
As with any medical procedure, a bursectomy comes with many potential risks. While not especially common, these risks are still a possibility and we at Cooper believe patients should be fully educated before making their final decision.
- Infection: Infection is a potential risk of any surgery, and that is true for bursectomy. The use of antibiotics during the surgery helps to minimize the possible risk of infection.
- Bleeding: Excessive bleeding during the recovery process or the surgery itself is a potential risk. This risk is often mitigated by the surgeon's expertise and careful monitoring during the procedure.
- Blood Clot Formation: Surgery can increase the risk of blood clot formation, potentially resulting in medical complications such as deep vein thrombosis (DVT). Measures such as physical therapy and various medications can help avoid this risk during the recovery process.
- Scarring: Any surgical procedure carries the risk of visible scars at the incision site. Scarring is highly dependent on the unique characteristics of each patient, and will be monitored closely on each follow-up visit.
- Allergic Reactions: Allergies should be communicated to the healthcare team at Cooper before the procedure, including any potential risk associated with anesthesia and the medications that will be provided during and after the procedure.
- Pain and Discomfort: Postoperative pain is common after a bursectomy, and while it is managed with pain medications throughout the recovery period, each person’s experience will be unique in terms of pain tolerance.
- Joint Stiffness or Weakness: Following a bursectomy, there is a risk of temporary joint stiffness or weakness, especially during the early stages of recovery. Physical therapy is crucial to address and minimize these issues.
Recovery after a Bursectomy
Immediate Post-Operative Period
The initial phase of recovery following a bursectomy is crucial for ensuring a smooth healing process for the weeks and months to come. Patients can expect to spend some time in the recovery room at Cooper, closely monitored by a team of specialists. The primary objective at this stage of recovery is pain management, including the use of medications when necessary. While individual experiences may vary at the stage, it is common for the hospital stay to extend several days while all symptoms are monitored closely and the recovery begins.
Mobilization and Physical Therapy
To prevent complications and enhance recovery, mobilization is encouraged early. Physical therapy will often begin during the hospital stay, tailored to the unique characteristics of that patient. Physical therapists work with patients to regain strength and range of motion, as well as improving the overall quality of life.
Follow-Up Care and Long-Term Recovery
Regular follow-up appointments with the team at Cooper are essential to track progress and address any potential concerns that arise during the recovery process. These appointments may involve imaging studies to monitor the surgical site and determine if any steps will need to be taken to address any potential complications should they arise.
Patients can typically expect a return to daily activities, including work and light exercise, within a few weeks to a couple of months, depending on individual progress. A personalized recovery plan will be developed by your doctors with your unique physicality and recovery progress in mind, and will traditionally include recommended diet, activity restrictions and recommendations, as well as ongoing physical therapy.
While most individuals experience significant improvement within the first few months, the full recovery timeline will vary considerably and may extend to up to a year.
Model Timeline
- Days 1-3: Hospital stay with close monitoring and pain management.
- Weeks 1-2: Gradual introduction of physical therapy, focusing on mobility.
- Weeks 3-6: Progressive increase in physical activity and incorporation of targeted exercises.
- Months 2-3: Return to daily activities, with ongoing physical therapy.
- Months 4-6: Continued rehabilitation, with a focus on building strength and endurance.
- Months 7-12: Integration of regular physical activity into daily routine, with periodic follow-up appointments.
- Beyond 1 Year: Sustained commitment to long-term recovery, with occasional check-ups to ensure ongoing well-being.