Within joints, there are small fluid-filled sacs which act as cushions for bones, and the muscles and tendons which are located near them. These fluid-filled cushions are called bursae (singular: bursa). Bursitis is a condition in which the main symptom is inflammation of one or more bursa.
Most commonly, the hips, elbows, or shoulder joints are affected; however bursitis may also develop in the knee, heel, or big toe. Bursitis inflammation is more likely to develop in joints that perform repetitive motions.
The most common treatment for bursitis is rest and anti-inflammatory medication. This treatment usually resolves most cases of the condition. However, for people who experience severe or chronic bursitis, surgery may be the most effective treatment in the long term.
The Bursectomy Procedure
Sometimes, bursitis does not respond to common types of treatment. In addition, the inflamed bursa may sometimes become infected, requiring more intervention than simple rest and over-the-counter medication. In such cases, a bursectomy may be needed to drain the bursa.
This fairly simple and only slightly invasive procedure involves draining the inflamed or infected sac to remove excess fluid. This process, called aspiration, involves the insertion of a fine, hollow needle into the bursa sac, through which fluid is removed. The patient undergoing this procedure may feel some pain; he or she may receive a topical anesthetic to keep discomfort to a minimum, but some pain may still be experienced.
If an infection is suspected, the fluid can be tested in a laboratory to determine what type of organism has caused the infection. Once the cause of infection has been established the patient can be prescribed drugs to eradicate it.
Another type of bursectomy, called an arthroscopic procedure, may be performed for a patient which chronic trochanteric bursitis. This condition affects the hip bursa, and cannot easily be treated via other surgical methods because the bursa of the hip is not easily accessible. In this laparoscopic procedure, surgical tools and a mini-camera are inserted through tiny incisions in the hip, and the tools are used to drain the bursa without removing it.
It is extremely important to ensure the joint is allowed to rest and heal for several weeks following any procedure. Often, bursitis develops as a result of repetitive motion, and serious damage may be done to the joint if repetitive motion is resumed before it has healed properly.
Mary Ann Porucznik, American Academy of Orthopedic Surgeons: Arthroscopic bursectomy works for stubborn trochanteric bursitis.
The Mayo Clinic on Bursitis
William C. Shiel Jr., MD, FACP, FACR. for Medicine.net: Bursitis