Osteoid Osteoma: CT-guided Percutaneous Radiofrequency Ablation and Follow-up in 47 Patients

Woertler, Klaus; Vestring, T; Boettner, Friedrich; Winkelmann, Winfried; Heindel, Walter; Lindner, Norbert

doi:10.1016/s1051-0443(07)61443-2

Cited by 257 publications

(164 citation statements)

References 26 publications

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“…Like some authors [16,23], we believe the diagnosis of OO is mainly clinical and radiographic, and we did not perform regular biopsy for tissue confirmation, a practice consistent with other studies [14,22,23]. However, the practice of not performing a biopsy is not universal and others have performed tissue sampling before RFA [5,11,21,24,30,31,40,43]. The duration of symptoms before the procedure varied from 8 months to 6.5 years.…”

Section: Methodssupporting

confidence: 57%

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

Akhlaghpoor

Aziz-Ahari

Shabestari

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Osteoid osteoma has a nidus surrounded by sclerotic bone with a size usually less than 20 mm. Its diagnosis is made on typical presentation of nocturnal pain and imaging findings. Excision of the niduses, which are often small and difficult to precisely identify, sometimes may result in resection of surrounding normal bone. Minimally invasive percutaneous treatments have been used to try to minimize resection of normal bone. Although minimally invasive radiofrequency ablation generally relieves pain, its ability to relieve pain is less well known in locations other than lower extremity long bones. Questions/purposes We determined the pain relief and complication rates after radiofrequency ablation of osteoid osteomas presenting in atypical locations and followed patients to assess possible recurrence or late complications. Patients and MethodsWe retrospectively reviewed 21 patients with osteoid osteomas in unusual locations (eg, hip, radioulnar joint, and proximal phalanx) in whom we used radiofrequency ablation. Postoperative activities were not restricted for any of the patients. We assessed the time for patients to become symptom free, their activity status, and possible recurrence or complications. The minimum clinical followup was 12 months (mean, 27.8 months; range, 12-37 months).

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Section: Methodssupporting

confidence: 57%

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

Akhlaghpoor

Aziz-Ahari

Shabestari

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Because a biopsy of the lesion was not always taken at the time of operative treatment, an argument could be made that a portion of patients in this study may not have had the condition in question [2,14,17]. Histological confirmation with minimal-access techniques is only available in approximately 36-75% of cases [4].…”

Section: Discussionmentioning

confidence: 99%

Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up

Sung

Seo

Shim

et al. 2007

International Orthopaedics (SICO

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The purpose of this study is to evaluate the efficacy of the computed tomography (CT)-guided percutaneous radiofrequency thermoablation (PRT) method with a minimum of 2 years follow-up. Twenty-eight patients who were followed for more than 2 years among 35 patients who underwent CT-guided PRT between April 1999 and May 2005 were included in this study. The mean age was 24.5 years (range 7-55 years) and the mean follow-up period was 40.1 months (range 24-66 months). With a radiofrequency electrode, the lesion was heated to 80°C or 90°C for 6.5 mins (range 3-9 mins). Clinical success was assessed at the out-patient clinic by symptoms and radiographs. Twenty-six patients (90%) experienced a total loss of symptoms and additional PRT also relieved the ongoing symptoms in all of the recurrent patients. PRT appears to be a safe and effective method for treating osteoid osteoma and is also effective in recurrent cases. This treatment modality is a minimally invasive procedure and is a good alternative to open surgical treatment.Résumé Le propos de cette étude est d'évaluer l'efficacité de cette méthode avec un minimum de deux ans de recul. 28 patients ont été suivis pendant deux ans parmi 35 patients ayant bénéficié entre avril 99 et mai 2005 d'une ablation d'ostéome ostéoide par radio fréquence, guidée sous scanner. L'âge moyen était de 24,5 ans (7 à 55) et le suivi moyen de 40,1 mois (24 à 66). L'électrode permet de chauffer la lésion de 80 à 90°C en moyenne pendant 6,5 minutes (de 3 à 9). 90% des patients (26 à 28) ont pu, grâce à cette méthode, avoir une disparition totale des symptômes et pour ceux qui gardaient une symptomatologie persistante ou récurrente, un geste complémentaire de thermo régulation a été réalisé. Cette méthode apparaît comme une méthode sûre et efficace dans le traitement des ostéomes ostéoides et également dans les récidives. Ce traitement est un traitement mini invasif tout a fait alternatif avec le traitement par voie chirurgicale sanglante.

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“…48 Since the first report by Rosenthal et al 49 in 1992, several studies have reported on percutaneous CT-guided RF ablation for the treatment of osteoid osteomas. 10,11,46,50,51 RF ablation requires only a small osseous access to the nidus to allow insertion of the electrode. Loss of bone is therefore minimal and does not result in significant bone weakening.…”

Section: Radiofrequency Ablation Of Intra-articular Osteoid Osteomamentioning

confidence: 99%

“…In most series, clinical success after RF ablation of osteoid osteomas varies between 73 and 100%, with few complications and a short hospital stay. 10,11,17,46,48,50,51,53,54 Vanderschueren et al 54 found that 87% of patients with a successful outcome reported relief of symptoms within 24 h and the remaining 13% within 2 weeks. Wortler et al 51 and Lindner et al 50 described complete symptom relief in all 58 patients at 1 week, and De Berg et al 17 described symptom relief in all 18 patients by 3 days.…”

Section: Radiofrequency Ablation Of Intra-articular Osteoid Osteomamentioning

confidence: 99%

“…54 Recurrence has been associated with a nidus diameter of 1.0 -1.5 cm. 50,51 The possible complications of RF ablation include bleeding, infection, pathological fracture, injury to adjacent neural structures, abscess formation, and skin and muscle burns. 52 In the present series, all the patients returned to normal daily activities immediately, with restriction of sports activities for 2 months.…”

Section: Radiofrequency Ablation Of Intra-articular Osteoid Osteomamentioning

confidence: 99%

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Radiofrequency Ablation of Intra-articular Osteoid Osteoma of the Hip

et al. 2006

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Diagnosis and treatment of intra-articular osteoid osteoma is challenging. We present 16 patients with intra-articular osteoid osteomas of the hip treated with percutaneous radiofrequency ablation. Eight osteoid osteomas were located in the femoral head, six in the femoral neck, and two in the acetabulum. Three of the 16 patients had had an incorrect previous diagnosis. Percutaneous radiofrequency ablation was a clinical and technical success in all 16 patients. Within the first 24 h after the procedure, pain improved in all patients. Five patients had pain relief within the first 3 days after the procedure, nine patients within the first week and two patients within 2 weeks. Residual or recurrent symptoms were not reported by the last follow-up. At the 12-month follow-up, computed tomography and magnetic resonance imaging showed complete ossification and bone regeneration at the site of the lesion in three patients, partial ossification in six patients and no changes in seven patients. Computed tomography-guided percutaneous radiofrequency ablation is a simple, minimally invasive, safe and effective method for the treatment of most intra-articular osteoid osteomas.

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Osteoid Osteoma: CT-guided Percutaneous Radiofrequency Ablation and Follow-up in 47 Patients

Cited by 257 publications

References 26 publications

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up

Radiofrequency Ablation of Intra-articular Osteoid Osteoma of the Hip

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