Factors associated with revision surgery for olecranon bursitis after bursectomy.

BACKGROUND The first aim of our study was to identify the factors associated with revision surgery after bursal excision in patients with olecranon bursitis. The secondary aims were to describe the revision rate of bursectomy and to assess which factors are associated with flap surgery after bursectomy and describe the most common complications after bursectomy of the olecranon bursa. METHODS We included 191 adult patients with olecranon bursitis who underwent an olecranon bursa excision between January 2002 and October 2018. Patients who were pregnant, patients with incomplete records of the primary surgery, and patients who underwent bursectomy during elbow arthroplasty were excluded. After manual chart review, we found 22 patients who underwent revision surgery. Bivariate analysis was performed to assess the association between revision surgery and patients characteristics, comorbidities, and clinical characteristics. Additionally, we collected data regarding postoperative complications and intra-operative variables such as use of drains, VAC therapy, and flap surgery. RESULTS The overall revision rate in our cohort was 11.5% (22 out of 191). Bivariate analysis showed that patients who underwent revision surgery were more frequently female (p = 0.004), had more often a history of ipsilateral (p = 0.020) or contralateral (p = 0.012) olecranon bursitis, and were more often diagnosed with rheumatoid arthritis (p = 0.001) or diabetes mellitus (p = 0.019). The most common complications were delayed wound healing (n=8, 4.2%) and osteomyelitis (n=8, 4.2%). Five patients (2.6%) underwent flap surgery. Bivariate analysis showed that patients with rheumatoid arthritis underwent flap surgery more frequently (p = 0.011). CONCLUSION The revision rate after bursectomy of an olecranon bursitis is 22 out 191 (11.5%). Patients with rheumatoid arthritis, diabetes mellitus, ipsi- and contralateral history of olecranon bursitis, and patients who were female had more frequently revision surgery after bursectomy of an olecranon bursitis. In addition, patients with rheumatoid arthritis underwent flap surgery more frequently after bursectomy. LEVEL OF EVIDENCE Level III; Retrospective Case-Control Design; Prognosis Study.