Treatment of chronic non-infectious prepatellar bursitis by selective debridement of arthroscopy

Abstract

Objective To retrospectively study the therapeutic effects of selective debridement and pressure dressing under arthroscope for treatment of chronic non-infective prepatellar bursitis. Methods From January 2011 to December 2015, 16 patients with chronic non-infectious prepatellar bursitis were treated in the department of orthopedics, Branch Hospital of Tibetan Office in Chengdu. All the patients had normal inflammatory index and no history of joint infection. There were 12 males and four females. The patient's history was one month to 13 months. Femoral nerve block combined anesthesia was performed. Arthroscopic exploration was performed with an arthroscopic probe placed at the 7 o'clock direction of the cyst, and the approach was established based on the location of the lesion tissue. The tough tissue at the proximal end was cut by shaver, while a proper excision was performed to the distal lesion tissue without hemostasis. The knee joint was fixed with braces at extension position. Knee flexion exercise was forbidden in three weeks after the surgery. Visual analogue score(VAS) was used for pain evaluation at preoperative and postoperative period, and at final follow-up. The knee function was assessed by Lysholm knee function score system and MRI was performed at the last follow-up. Results Three patients were outpatient follow-up, 13 cases were followed up by mobile WeChat. The average follow-up time was (16±4) months. All the wounds were type I/class A healing; postoperative weight-bearing and flexion exercises began three weeks later. In four weeks postoperatively, the patients could cflex the knee over 120 °, the mean range of motion was (131±10) °. VAS score was (2.1±1.0) on average. Lysholm knee function scores were excellent in 14 cases, good in two cases; the excellent and good rate was 100%. MRI showed that no effusion in the anterior bursa had. Conclusion Arthroscopic debridement for treatment of chronic noninfectious prepatellar bursitis has small wounds and satisfactory results, which is an effective surgical method. Mobile phone WeChat is a convenient tool for patient follow-up. Key words: Arthroscopy; Patella; Bursitis; Debridement