Excision Olecranon Bursa

If your symptoms do not respond after 12 –18 months of nonsurgical treatments, your doctor may recommend surgery. Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.

Open surgery. The most common approach to removing / excising the olecranon bursa is open surgery. This involves making an incision over the elbow and debriding the degenerate tendon ends. Open surgery is usually performed as a day case surgery. At surgery the bursa is carefully removed taking care not to damage the skin. If there is a large spur then the triceps tendon is split and the spur is removed. Sometimes the surgeon may have to insert an anchor to repair the tendon ends.

At the end of surgery, the wound is closed with dissolvable sutures and tied over the skin. Butterfly stitches, splash proof dressing and a pad is applied, and the arm rested in a sling.

Questions that are often asked

Is the surgery necessary?

If your symptoms do not respond after 12 –18 months of nonsurgical treatments, your doctor may recommend surgery.

Before Admission:

No food for 6 hours, or drink for 2 hours, prior to surgery.
Please avoid smoking for 12 hours prior to surgery.
Please continue to take all your medication as advised by the preassessment team.

What happens on the day of surgery?

You will need to report to the main reception on arrival. You will be shown to your room where you will be checked in by the nurse and also see Prof. Singh and the anaesthetist. This will give you chance to ask any questions before surgery. You will also be given an approximate time of your procedure. Please read the instructions on ‘Preparing for Surgery’.

What are the possible complications?

Scar: You will have a 4 – 5 cm scar on the back of the elbow. This area can be firm to touch & tender for 2 – 3 months. This can be helped by massaging the area with moisturizing cream once the wound has healed.
Infection: Can occur after any operation. This would be treated with antibiotics. This is uncommon following surgery for tennis elbow
Nerve Damage: The nerves running around the elbow can be damaged during the surgery. This is rare after tennis elbow surgery
Bleeding: Can cause a collection of blood under the stitches which can cause wound problems. Tell the surgeon if you are on anticoagulants or aspirin
CRPS / Stiffness: About 5% (1 in 20) of people are sensitive to surgery and their hand and whole arm may become swollen, painful and stiff after any operation. This problem cannot be predicted but will be watched for afterwards and treated with therapy.
Continued symptoms:Some patients may have on going symptoms even after surgery and may need further investigations.
Recurrence: There is a small risk that the bursa may reform and cause symptoms again.

What kind of anaesthesia is used?

The operation is most commonly performed under General Anaesthesia i.e you will be put to sleep. At the end of the surgery I put local anaesthetic around the wound which gives good pain relief. The procedure can also be performed with awake anaesthesia – please discuss with your surgeon if you wish to consider.

How long will I be in the hospital?

The surgery is done as a day case and should home within a few hours.

After hospital care:

Sling: After your surgery, you will be fitted with a high arm sling, which is to be used for 48 – 72 hoursweeks.
Medication: The local anaesthetic lasts between 4 to 8 hours. Patients are encouraged to start taking painkillers before the pain starts i.e. on return home and for at least 48 hours
Wound care &Removal of stitches: At the end of the surgery you have dissolvable sutures to close the skin which are tied over the skin. The sutures will need to be removed at 14 days after surgery which can be performed at your GP practice or nurse at the hospital or by the therapist
Follow-up orthopaedic clinic: You will need to be reviewed in clinic after your operation. This is usually 2 –4weeks after surgery.
Physical Therapy At the time of your surgery you will be referred to a therapist who will help your recovery.
Return to Work: Managerial or Supervisory: 2– 3 weeks, Light Manual: 4 – 6 weeks (e.g. clerical, secretarial), Heavy Manual: 6 – 10 weeks (ground worker, HGV). Please discuss with your consultant / therapist if you have any queries.
Drivingyou may be able to drive once the pain is under control. Please let your Motor Insurance Company aware of your procedure.