Follow-up of thirty-three computed-tomography-guided percutaneous radiofrequency thermoablations of osteoid osteoma

Abstract

Purpose This study aimed to determine the mid-and longterm success and complication rates of radiofrequency ablation (RFA) in treatment of osteoid osteoma (OO). Furthermore we were interested in the value of bone biopsy when using a core-drill before the radiofrequency ablation. Methods We retrospectively analysed data of 33 patients (33 osteoid osteomas, 22 males, 11 females) who underwent computed-tomography (CT) guided radiofrequency ablation between 1998 and 2005. The patients had a mean age of 20 years (range, five to 50 years). They were monitored for a mean follow-up of 92 months (range, 60-121 months). Results Lesions were located as follows: 11 cases in the proximal femur, five in the femoral shaft, six in the tibia, one in the calcaneus, two in the metatarsals (second and fourth metatarsals), one in the os cuneiforme mediale, six in the humeral and one in the ulnar shaft. Within the presented time frame 32 of 33 patients were successfully treated and had no more complaints. In one of 33 patients relapse occurred after 28 months and RFA was repeated. There were no complications associated with the procedure. Biopsy obtained prior to thermocoagulation with the help of a core-drill was able to prove diagnosis in all patients (100%). Conclusions These results indicate that the presented technique of CT guided RFA combined with the use of a core-drill for biopsy prior to RFA treatment is a highly effective, efficient, minimally invasive and safe method for the treatment of OO, yielding a success rate of 97% combined with a 100% histological verification of the diagnosis after a minimum follow-up period of five years.

Osteoid osteoma of the proximal femur: Treatment by percutaneous bone resection and drilling (PBRD). A report of 44 cases

“…The frequency of this entity confirms the need for this study. Many of the studies of percutaneous treatment, either by drilling [7][8][9][10] or thermoablation [11][12][13][14][15][16][17][18][19], have not differentiated between the femoral neck and other locations in the reported cases. The advantage of our series is that it specifically focuses upon this location.…”

“…Results of radiofrequency thermoablation have been good (97% for Neumann et al [14] and 92% for Hoffman et al [13]). Rosenthal et al [11] reported recurrence in 7/74 femoral osteoid osteomas, while Hoffman et al did not report any.…”

Minimal invasive intralesional excision of extremity-located osteoid osteomas in children

“…There were 29 male and 18 female patients, with a mean age of 10.5 years (range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] at presentation. The majority of the solitary lesions were localized in diaphyseal or metaphyseal regions of the lower (28) and upper (13) extremity long bones.…”

“…PRT is currently suggested as the treatment of choice for extraspinal osteoid osteomas because it is minimally invasive, safe, effective, and repeatable, with reported success rates ranging from 80 to 100% [9][10][11][12][13][14][15][16][17]. Compared with open surgical excision, this technique is associated with lower risks of complications and morbidity.…”

“…Currently, the most commonly preferred treatment methods include excision of the nidus with minimal invasive intralesional extended curettage [6][7][8] and percutaneous radiofrequency thermoablation (PRT) of the lesion under computerized tomography (CT) guidance [9][10][11][12][13][14][15][16][17].…”