Hydrothermal ablation in recurrent or chronic olecranon bursitis: a prospective study

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Regenerative Medicine

Background:

• Olecranon bursitis often presents with persistent or recurrent symptoms, posing treatment challenges.
• Traditional bursectomy, while common for refractory cases, is associated with significant complication rates.
• Hydrothermal ablation presents a novel approach for managing chronic or recurrent olecranon bursitis.

Purpose of the Study:

• To investigate the safety and efficacy of hydrothermal ablation for treating olecranon bursitis.
• To determine an optimal irrigation temperature window for hydrothermal ablation through an animal trial.
• To evaluate the clinical outcomes and adverse events associated with hydrothermal ablation in human patients.

Main Methods:

• A pilot animal study established a safe irrigation temperature range.
• Human patients with chronic, recurrent, or refractory olecranon bursitis underwent irrigation with heated saline (50-52°C) at 3 mL/s for 180 seconds.
• Outcomes were assessed over 6 months, including adverse events, bursal volume via ultrasonography, and patient-reported scores (QuickDASH, PGIS, CGIS), alongside return to activity.

Main Results:

• Seventy-five percent (18/24) of treated elbows showed successful outcomes with symptom remission or significant improvement within 6 weeks and no recurrence at 6 months.
• A mean bursal volume reduction of 91.9% was observed in responding patients.
• Statistically significant improvement in QuickDASH scores (13.6 to 3.1) and full return to work within 6 weeks were noted, with no serious adverse events.

Conclusions:

• Hydrothermal ablation is a safe and effective treatment for chronic or recurrent olecranon bursitis.
• This method demonstrates comparable efficacy to open bursectomy but with a lower complication profile.
• Optimal treatment temperatures range between 50°C and 52°C, with no increased efficacy at higher temperatures.