Injury or chronic overuse of the elbow tip or the kneecap can lead to the development of an effusion of the bursa in these places. Fluid and blood then fill the bursa.  The swelling slowly goes down with the remission of the acute reaction, but the walls of the bursa remain thick and rough. Depending on the situation, acute inflammations with accumulations of pus can develop in the bursa, and sometimes recurring accumulations of fluid or thickened and scarred bursa walls cause discomfort.

A radical removal of the affected bursa is usually the only permanent cure. We perform this procedure under regional anesthetic; the bursa is exposed and completely removed through an s-shaped skin incision above the elbow or over the kneecap. The affected joint should  be rested for a few days following the surgery, and sometimes we apply a soft plaster splint for a few days.