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Olecranon Bursitis

Olecranon bursitis: aseptic vs septic etiology, diagnostic aspiration, and treatment algorithms including drainage & antibiotic guidance.

35 citationsUpdated Sep 2026
Illustration: Olecranon Bursitis

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Overview

Olecranon bursitis presents a diagnostic challenge because physical examination and laboratory data often overlap between septic and aseptic etiologies [1]. Nontuberculous mycobacterial infection must be considered in any patient with a swollen bursa and a protracted course, regardless of immune status [10]. The presence of cords within the olecranon bursa is associated with lower patient satisfaction following surgical excision compared to patients without cords [19]. For initial management of nonseptic olecranon bursitis, nonsurgical approaches are significantly more effective and safer than surgical intervention, a conclusion supported primarily by level IV evidence [9]. Recent literature further demonstrates adverse effects associated with intrabursal injections and surgery compared with noninvasive management for the initial treatment of nonseptic cases [17].

In uncomplicated septic olecranon bursitis, deferring aspiration is a reasonable treatment option [18]. Empirical management of uncomplicated septic cases has proven effective, with no patients requiring bursectomy, whereas 8 of 11 patients in the traditional aspiration group required the procedure [14]. For recurrent olecranon bursitis refractory to conservative management, intrabursal doxycycline sclerotherapy may serve as an effective alternative to surgical bursectomy [11]. While bursectomy is the commonly performed therapy, definitive treatment conclusions cannot be drawn due to low evidence quality [16]. Surgical resection of chronic olecranon bursitis should not be considered lightly [2], and the revision rate after bursectomy is 11.5% [6].

Surgical options for unresponsive or recalcitrant patients include open excisional procedures, which allow for complete removal of pathological bursal tissue [4], and arthroscopy, which is increasingly considered a suitable modality [4]. Endoscopic bursectomies are a useful treatment option for recalcitrant cases [5], with patients experiencing no recurrences or wound-healing complications necessitating return to the operating room [3]. Endoscopic debridement combined with compression suture offers advantages including minimal invasiveness, rapid recovery, and a low recurrence rate [20]. The extrabursal endoscopic approach provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon [8]. Hydrothermal ablation at temperatures between 50C and 52C is a safe treatment option for recurrent or chronic olecranon bursitis, offering fewer complications than open bursectomy with comparable efficacy [13]. Patients with refractory olecranon bursitis, particularly if aseptic, tend to gain significant physical health benefits from open bursectomy [12], which appears to give satisfactory results for chronic cases [7]. Bursal suture repair is a viable alternative to bursectomy in selected patients with chronic traumatic olecranon bursitis, combining functional and cosmetic benefits [15]. The medial single-window approach utilizing a triceps-on technique provides safe and adequate exposure of the elbow joint while reducing potential complications associated with dissection through the olecranon bursa [22].

Anatomy & Pathophysiology

Bony Anatomy

The olecranon and coronoid process form the greater sigmoid notch, which articulates with the trochlea of the distal humerus [31]. This intrinsic anatomy of the olecranon-coronoid articulation allows flexion/extension movement of the elbow joint and provides stability for the elbow [31]. The olecranon serves as the insertion for the triceps tendon, which blends with the periosteum of the proximal ulna [31]. Due to its exposed position, the olecranon is vulnerable to direct trauma and violent muscular contractions from the triceps [31].

In children, the olecranon is predominantly cartilage, particularly in younger children, resulting in a smaller chance of fracture occurring with a direct blow [32]. The thick periosteum and relatively thin metaphyseal cortex of the olecranon in children predispose it to minimally displaced greenstick fractures [32].

Pathophysiology

Olecranon bursitis is a condition where the bursal cavity, superficial to the olecranon, becomes inflamed [23]. This condition can occur with or without infection [23] and is often predisposed by repeated minor trauma from external pressure [23]. The olecranon bursa sometimes becomes enlarged as a result of pressure or friction [42]. When the olecranon bursa is painful, the cause is more likely to be infection, gout, or rheumatoid arthritis [42].

Gout is suspected in olecranon bursitis if there is a history of previous attacks, if the condition is bilateral, if there are tophi, or if X-ray shows calcification in the bursa [42]. Rheumatoid arthritis causes both swelling and nodularity over the olecranon [42]. In almost all cases of rheumatoid arthritis affecting the olecranon, the condition is associated with a typical symmetrical polyarthritis [42]. In the late stages of rheumatoid arthritis, erosion of the elbow joint may cause marked instability [42].

Classification

Differential Diagnosis: Pyoderma gangrenosum must be considered in the differential diagnosis whenever a patient presents with ulcerative cutaneous lesions that resemble an infectious process such as olecranon bursitis [26].

Rheumatoid Arthritis: In the rheumatoid patient, septic arthritis of the elbow joint can mimic septic olecranon bursitis [29]. The fact that the elbow joint may also be involved should be suspected in the rheumatoid patient who has what appears to be a septic olecranon bursitis [29].

Clinical Presentation

Providers should maintain a high index of suspicion for triceps tears in patients with specific risk factors, utilizing a comprehensive musculoskeletal examination to ensure accurate and timely diagnosis [46].

Chronic Arthropathy

Gout is suspected when the clinical picture includes a history of previous attacks, bilateral involvement, the presence of tophi, or X-ray evidence of calcification within the bursa [42]. It is not easy to distinguish gout from acute infection unless pus is aspirated [42]. In almost all cases, rheumatoid arthritis-associated olecranon swelling is associated with a typical symmetrical polyarthritis [42].

Investigations

MRI: Magnetic resonance imaging is probably the method of choice for determining both the development of the bursae and their fluid content [27]. Early imaging, such as ultrasound or MRI, may have decreased the likelihood of a second surgery by alerting the surgeon to the underlying process [79]. Clinicians should be aware of the possibility of other infections in cases of uncalcified synovial chondromatosis and rice bodies, as these can have similar visual and MRI characteristics [80].

Other Considerations: In the rheumatoid patient, septic arthritis of the elbow joint can mimic septic olecranon bursitis [29]. The fact that the elbow joint may also be involved should be suspected in the rheumatoid patient who has what appears to be a septic olecranon bursitis [29].

Treatment

Non-Operative

Nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management [9]. Recent literature demonstrates adverse effects of intrabursal injections and surgery compared with noninvasive management for the initial treatment of nonseptic olecranon bursitis [17]. Most chronic olecranon bursitis is managed supportively with ice, compression, and modification of activities, including protective padding [45]. Empirical management of uncomplicated septic olecranon bursitis has been found to be effective, with no patients requiring bursectomy [14].

Operative

Indications: The available evidence did not support the central European concept of immediate bursectomy in cases of septic bursitis [24]. Most surgeons are reluctant to perform percutaneous drainage or surgical excision as first-line treatment for chronic olecranon bursitis, for fear of causing a chronic draining sinus or infection [45].

Surgical Approach / Technique: The endoscopic approach provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon [8]. Endoscopic debridement combined with compression suture for aseptic olecranon bursitis offers advantages including simple operation, minimal invasiveness, minimal postoperative pain, rapid recovery, a low recurrence rate, and satisfactory overall efficacy [20]. The operation for chronic olecranon bursitis appears to give satisfactory results [7]. Excision has been curative for all lesions of the olecranon bursa, whereas multiple medications have been tried for cutaneous and systemic infections without clear-cut success [21].

Other Considerations: Patients with olecranon cords were less satisfied after surgical excision compared to those without cords [19]. In this population, patients who underwent endoscopic olecranon bursectomy experienced no recurrences or wound-healing complications necessitating return to the operating room [3]. This approach provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon [8].

Diagnostic and Management Challenges

Distinguishing between septic and aseptic olecranon bursitis can be difficult because physical and laboratory data overlap [1].

Recovery

Other Considerations: Recovery trajectories following olecranon bursectomy vary by surgical approach and specific pathology. In patients undergoing endoscopic olecranon bursectomy for recalcitrant olecranon bursitis, no recurrences or wound-healing complications necessitating return to the operating room were observed [3]. Endoscopic debridement combined with compression suture for aseptic olecranon bursitis is associated with minimal postoperative pain and rapid recovery [20]. Hydrothermal ablation for recurrent or chronic olecranon bursitis is associated with fewer complications than open bursectomy [13]. In a patient with a greatly delayed complication of medial epicondyle injury, full range of movement at the elbow with no obvious deformity was present at 6 weeks [43].

Key Evidence

  • [L5] Distinguishing between septic and aseptic olecranon bursitis can be difficult because the physical and laboratory data overlap. [1] (10.1016/j.jse.2015.08.032)
  • [L4] In this population, patients who underwent endoscopic olecranon bursectomy experienced no recurrences or wound-healing complications necessitating return to the operating room. [3] (10.1016/j.asmr.2023.100832)
  • [L4] In unresponsive patients, although open excisional procedures allow to completely remove the pathological bursal tissue, arthroscopy is increasingly being considered as a suitable new modality of management. [4] (10.1016/j.surge.2012.02.002)
  • [L5] Endoscopic bursectomies are a useful treatment option for patients with recalcitrant olecranon bursitis. [5] (10.1016/j.eats.2023.09.004)
  • [L3] The revision rate after bursectomy for olecranon bursitis was 11.5%. [6] (10.1016/j.jse.2020.09.033)
  • [L4] The operation appears to give satisfactory results for chronic olecranon bursitis. [7] (10.1016/s0020-1383(77)80050-8)
  • [L4] This approach provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon. [8] (10.1097/bth.0b013e31829c0535)
  • [L4] Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. [9] (10.1007/s00402-014-2088-3)
  • [L4] Nontuberculous mycobacterial olecranon bursitis should be considered in any patient with a swollen bursa and protracted course, regardless of immune status. [10] (10.1016/j.jse.2008.07.009)
  • [L4] This may be an effective alternative to surgical bursectomy for patients with recurrent olecranon bursitis refractory to conservative management. [11] (10.1016/j.jhsg.2024.03.006)
  • [L4] Patients with refractory olecranon bursitis, particularly if aseptic, tend to gain significant physical health benefits from open bursectomy. [12] (10.7759/cureus.43696)
  • [L4] Hydrothermal ablation at temperatures between 50C and 52C is a safe treatment option for recurrent or chronic olecranon bursitis with fewer complications than open bursectomy and a comparable efficacy. [13] (10.1016/j.jse.2024.03.021)
  • [L4] Empirical management of uncomplicated septic olecranon bursitis was found to be effective with no patients requiring bursectomy, whereas 8 of 11 patients in the traditional aspiration group required bursectomy. [14] (10.1016/j.jhsa.2019.06.012)
  • [L5] Bursal suture repair is a viable alternative to bursectomy in selected patients with chronic traumatic olecranon bursitis, combining functional and cosmetic benefits. [15] (10.1016/j.xrrt.2025.100597)
  • [Paper] Bursectomy is the commonly performed therapy, but definitive treatment conclusions cannot be drawn due to low evidence. [16] (10.1007/s00402-017-2690-2)
  • [L5] Older studies showed resolution with injections and surgery, but more recent literature demonstrates adverse effects of intrabursal injections and surgery compared with noninvasive management for initial treatment of nonseptic olecranon bursitis. [17] (10.1016/j.jhsa.2021.02.006)
  • [L4] Deferring aspiration in uncomplicated septic olecranon bursitis is a reasonable treatment option. [18] (10.1016/j.jhsa.2018.06.059)
  • [L4] Patients with olecranon cords were less satisfied after surgical excision compared to those without cords. [19] (10.1016/j.jse.2015.04.016)
  • [L4] Endoscopic debridement combined with compression suture for the treatment of aseptic olecranon bursitis has several advantages: simple operation, minimal invasiveness, minimal postoperative pain, rapid recovery, a low recurrence rate, and satisfactory overall efficacy. [20] (10.1186/s13018-024-05090-3)
  • [Case_report] Excision has been curative for all lesions of the olecranon bursa, whereas multiple medications have been tried for cutaneous and systemic infections without clear-cut success. [21] (10.2106/00004623-198062050-00024)
  • [L4] The medial single-window approach utilizing a triceps-on technique provides safe and adequate exposure of the elbow joint while reducing potential complications associated with dissection through the olecranon bursa. [22] (10.1016/j.xrrt.2025.08.016)
  • [L4] [23] (10.1177/1758573214532787)
  • [L1] The available evidence did not support the central European concept of immediate bursectomy in cases of septic bursitis. [24] (10.1007/s00402-013-1882-7)
  • [Case_report] PG must be considered in the differential diagnosis whenever a patient presents with ulcerative cutaneous lesions that resemble an infectious process such as olecranon bursitis. [26] (10.1016/j.jse.2014.06.032)
  • [L4] MR imaging is probably the method of choice for determining both the development of the bursae and their fluid content. [27] (10.1007/s002560050117)
  • [L4] In the rheumatoid patient, septic arthritis of the elbow joint can mimic septic olecranon bursitis, and the fact that the elbow joint may also be involved should be suspected in the rheumatoid patient who has what appears to be a septic olecranon bursitis. [29] (10.2106/00004623-198062060-00022)
  • [L5] The patient had full range of movement at the elbow with no obvious deformity at 6 weeks and no weakness in the limb. [43] (10.1016/s0020-1383(98)00141-7)
  • [L3] [45] (10.1016/j.jhsa.2010.12.030)
  • [Case_report] Providers should maintain a high index of suspicion for triceps tears in patients with specific risk factors and comprehensive musculoskeletal examination to ensure accurate and timely diagnosis. [46] (10.1016/j.xrrt.2024.02.002)
  • [L5] Early imaging, such as ultrasound or MRI, may have decreased the likelihood of a second surgery by alerting the surgeon to the underlying process. [79] (10.1055/s-0040-1701149)
  • [Case_report] Uncalcified synovial chondromatosis and rice bodies can have similar visual and MRI characteristics; therefore, clinicians should be aware of the possibility of other infections in cases of this type. [80] (10.5397/cise.2019.22.1.46)

References

[1] Olecranon bursitis. Journal of Shoulder and Elbow Surgery. 2016. DOI: 10.1016/j.jse.2015.08.032

[2] Complications following resection of the olecranon bursa. Acta Orthopaedica Belgica. 2006.

[3] No Wound Healing Complications or Recurrences Were Seen and a High Level of Satisfaction Was Reported in Patients Who Underwent Endoscopic Olecranon Bursectomy for Recalcitrant Olecranon Bursitis. Arthroscopy, Sports Medicine, and Rehabilitation. 2024. DOI: 10.1016/j.asmr.2023.100832

[4] Diagnosis and management of olecranon bursitis. The Surgeon. 2012. DOI: 10.1016/j.surge.2012.02.002

[5] Endoscopic Olecranon Bursectomy in the Treatment of Recalcitrant Olecranon Bursitis: Patient Selection and Operative Technique. Arthroscopy Techniques. 2023. DOI: 10.1016/j.eats.2023.09.004

[6] Factors associated with revision surgery for olecranon bursitis after bursectomy. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2020.09.033

[7] A useful procedure in the treatment of chronic olecranon bursitis. Injury. 1977. DOI: 10.1016/s0020-1383(77)80050-8

[8] Olecranon Extrabursal Endoscopic Bursectomy. Techniques in Hand & Upper Extremity Surgery. 2013. DOI: 10.1097/bth.0b013e31829c0535

[9] Treatment of olecranon bursitis: a systematic review. Archives of Orthopaedic and Trauma Surgery. 2014. DOI: 10.1007/s00402-014-2088-3

[10] Nontuberculous mycobacterial olecranon bursitis: Case reports and literature review. Journal of Shoulder and Elbow Surgery. 2009. DOI: 10.1016/j.jse.2008.07.009

[11] Intrabursal Doxycycline Sclerotherapy for Recurrent Olecranon Bursitis of the Elbow: A Case Control Study. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.006

[12] Clinical Outcomes Following Open Olecranon Bursa Excision for Septic and Aseptic Olecranon Bursitis: An Observational Study. Cureus. 2023. DOI: 10.7759/cureus.43696

[13] Hydrothermal ablation in recurrent or chronic olecranon bursitis: a prospective study. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2024.03.021

[14] Empirical Treatment of Uncomplicated Septic Olecranon Bursitis Without Aspiration. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.06.012

[15] Olecranon bursal repair for chronic traumatic bursitis: a surgical technique. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.100597

[16] Treatment and outcome with traumatic lesions of the olecranon and prepatellar bursa: a literature review apropos a retrospective analysis including 552 cases. Archives of Orthopaedic and Trauma Surgery. 2017. DOI: 10.1007/s00402-017-2690-2

[17] Clinical Management of Olecranon Bursitis: A Review. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2021.02.006

[18] Empiric Treatment of Uncomplicated Septic Olecranon Bursitis Without Aspiration. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.06.059

[19] The existence of cords in olecranon bursae. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2015.04.016

[20] Clinical efficacy of endoscopic debridement combined with compression suture in the treatment of recalcitrant aseptic olecranon bursitis. Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-05090-3

[21] Protothecal olecranon bursitis. A case report and review of the literature.. The Journal of Bone & Joint Surgery. 1980. DOI: 10.2106/00004623-198062050-00024

[22] Medial single-window approach to the elbow: a triceps-on technique that does not violate the olecranon bursa. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.08.016

[23] Olecranon bursitis: a systematic overview. Shoulder & Elbow. 2014. DOI: 10.1177/1758573214532787

[24] Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm. Archives of Orthopaedic and Trauma Surgery. 2013. DOI: 10.1007/s00402-013-1882-7

[26] Case report: misdiagnosed olecranon bursitis: pyoderma gangrenosum. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2014.06.032

[27] The US,CT and MR findings of cubital bursitis: a report of five cases. Skeletal Radiology. 1996. DOI: 10.1007/s002560050117

[29] Septic arthritis presenting as olecranon bursitis in patients with rheumatoid arthritis. A report of three cases.. The Journal of Bone & Joint Surgery. 1980. DOI: 10.2106/00004623-198062060-00022

[31] Aaos Comprehensive Orthopaedic Review 3. Fractures of the Elbow > II. Olecranon Fractures.

[32] Tachdjian S Pediatric Orthopaedics From The Texas Scottish Rite Hospital For Children E Book. Pigmented Villonodular Synovitis and Giant Cell Tumor of the Tendon Sheath > Olecranon Fractures.

[42] Apley And Solomon S Concise System Of Orthopaedics And Trauma. OLECRANON BURSITIS.

[43] Greatly delayed complication of medial epicondyle injury. Injury. 1998. DOI: 10.1016/s0020-1383(98)00141-7

[45] Chronic Olecranon Bursitis. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.12.030

[46] Full-thickness triceps tears misdiagnosed as olecranon bursitis: a case report. JSES Reviews, Reports, and Techniques. 2024. DOI: 10.1016/j.xrrt.2024.02.002

[79] Epidermoid Cyst in an Infected Olecranon Bursa. Journal of Hand and Microsurgery. 2020. DOI: 10.1055/s-0040-1701149

[80] Synchronization of Synovial Chondromatosis and Mycobacterium intracellurae Infection in Olecranon Bursitis: A Case Report. Clinics in Shoulder and Elbow. 2019. DOI: 10.5397/cise.2019.22.1.46

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a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.