Percutaneous radiofrequency ablation in osteoid osteoma: Tips and tricks in special scenarios

Cuesta, Helena; Martel, José; Horcajadas, A.; Kassarjian, Ara; Caravaca, G. Rodríguez

doi:10.1016/j.ejrad.2018.03.008

Cited by 19 publications

(10 citation statements)

References 32 publications

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“…Many surgical techniques like en bloc resection, cortical peeling or burr-down with curettage, percutaneous curettage and alcoholization, laser coagulation, thermoregulation or radiofrequency ablation were defined [22–24]. En bloc resection requires bone grafting, and hand region is narrow for the percutaneous techniques [24, 25]. Cortical peeling is technically more difficult, especially with thick sclerosis, stripping of the cortex may not always be provided.…”

Section: Discussionmentioning

confidence: 99%

Hand osteoid osteoma: evaluation of diagnosis and treatment

Erdoğan

Gürkan

2019

Eur J Med Res

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BackgroundOO (osteoid osteoma) is a common, osteoblastic, benign bone tumor but rarely seen in the hand region. There is still some debate about the diagnosis and treatment of hand OOs. In the present study, we aimed to evaluate the epidemiology, radiologic features, surgical treatment options and functional outcomes.MethodsBetween January 2003 and December 2014, surgically treated and pathologically verified 9 hand OO cases were investigated retrospectively. The preoperative and postoperative clinical outcome scores were calculated using the M2-DASH (Manchester-Modified Disabilities of Arm Shoulder and Hand) Score.ResultsLesion locations were as follows: middle phalanx in 2/9 (22%) patients (2nd and 4th digit), proximal phalanx in 6/9 (67%) patients (one 4th, two 2nd and three 5th digits) and metacarpal (2nd) in 1/9 (11%) patient. Incidence of nidus formation was 6/9 (67%) on X-ray, 7/9 (78%) on CT imaging and 2/9 (22%) on MR imaging. The mean time to diagnosis was 13.22 ± 5.44 months. Preoperative mean M2-DASH score was 41 ± 6 and postoperative was 7.4 ± 8.6.ConclusionOsteoid osteoma is usually seen below 25 years, and rarely found over 40 years of age. There is male dominance with a male to female ratio of 3:1. Delay of diagnosis may be encountered because of many differential diagnoses. When OO is suspected, CT imaging should be taken before the MR imaging. Because of superiority in soft tissue imaging, MR imaging should be an alternative tool in complex cases.

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Section: Discussionmentioning

confidence: 99%

Hand osteoid osteoma: evaluation of diagnosis and treatment

Erdoğan

Gürkan

2019

Eur J Med Res

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“…A total of 1286 cases involving RFA treatment for OO were analysed, including 198 (15.4%) cases of intra-articular or intra-capsular OO located within various joints counting the elbow joint (Table 3 ) [ 4 , 19 , 28 – 32 , 44 – 51 ]. The average age of patients was 19.0 ± 6 (range, 12 to 30) years.…”

Section: Resultsmentioning

confidence: 99%

Comparison of arthroscopy versus percutaneous radiofrequency thermal ablation for the management of intra- and juxta-articular elbow osteoid osteoma: case series and a literature review

Knežević

Bojanić

2022

BMC Musculoskelet Disord

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Background Today, intra-articular and juxta-articular osteoid osteomas are treated with arthroscopy and radiofrequency thermal ablation. However, for the case of an elbow joint, arguments are made for the use of a minimally invasive technique to be the optimal choice. This study aims to analyse our experiences of arthroscopically treated elbow osteoid osteomas and to compare it with the published results of both techniques. Methods The retrospective study analyses the patients who underwent elbow arthroscopy ablation of an elbow osteoid osteoma at a single institution from January 2014 until March 2020. Clinical and diagnostic features, success and treatment failure rates, complications and tumour recurrence rates were all compared to 13 studies of intra-articular elbow osteoid osteoma arthroscopic ablation and 15 studies involving radiofrequency thermal ablation of intra-articular osteoid osteoma within different joints. Results Four males and two females, with a mean age of 19.3 years, were encompassed. All the patients had immediate postoperative pain relief and improved range of motion. No tumour recurrences were observed during a median of 21.7 months. The literature review yielded 86.4% success rate, 68.2% successful biopsies, one minor complication and no recurrences following the arthroscopic ablation of an elbow osteoid osteoma; while radiofrequency thermal ablation of an intra-articular elbow osteoid osteoma yielded 96.3% success rate, 33.3% successful biopsies, no complications and 3.7% recurrence rate. Conclusions Our results are consistent with the published literature proving that arthroscopic ablation is an efficient method with low treatment failure rates and no recurrences in treating intra- and juxta-articular elbow osteoid osteomas. Advantages of arthroscopic ablation stem from the ability to visualise and safely deal with the lesion and the joint’s reactive changes resulting in high biopsy rates, no recurrences and better postoperative elbow’s range of motion. Still, the technique selection should be personalised considering the medical expertise of every institution.

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“…All the CT-guided RFA showed a much higher radiation exposure than that of the reported O-arm navigated RFA ( Table 3 ). Most of these reported studies showed a low recurrence and complication rate with variations ( 12 , 13 ), which may be explained by the difference in localization of the lesion and the surgeon's experience in operation. Rimondi et al ( 14 ) retrospectively studied 557 patients who received CT-guided RFA, and found that the clinical results were greatly improved via regulating the temperature and time of RFA.…”

Section: Discussionmentioning

confidence: 99%

“…Over the decades, minimally invasive surgery represented by the CT-guided surgery and percutaneous RFA has become the trend worldwide in the treatment of OO ( 21 ). Many studies have demonstrated that CT-guided RFA is an acceptable strategy with minimal damage and fewer complications in the treatment of OO compared with open excision surgery ( 12 ). However, with the increasing usage of such CT guidance, radiation exposure has become a main concern, especially for young children, who are most susceptible to this disease.…”

Section: Discussionmentioning

confidence: 99%

O-Arm-Navigated, Robot-Assisted Versus Conventional CT Guided Radiofrequency Ablation in Treatment of Osteoid Osteoma: A Retrospective Cohort Study

et al. 2022

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BackgroundOsteoid osteoma is a common benign bone tumor, and clinically there is severe local pain that typically worsens at night. The conventional CT-guided radiofrequency ablation (RFA) was widely used in the treatment of osteoid osteoma (OO), which could result in some radiation-related and imprecise complications due to the overdose of radiation exposure. This study aimed to compare the surgical effect of robot-assisted RFA with O-arm navigation and conventional CT-guided RFA in the treatment of OO.MethodsSixty-two patients who underwent robot-assisted RFA with O-arm navigation (Robot-RFA, n = 24) or CT-guided RFA (CT-RFA, n = 38) were included in this retrospective cohort study. The mean follow-up time was 23.3 months. The intra-operative data, primary technical success rate, visual analog scale (VAS), and post-operative complications were analyzed.ResultsPrimary technical success was obtained in 23 patients who had robot-assisted RFA, and 35 patients who had conventional CT-guided RFA. One patient in Robot-RFA group and three patients in CT-RFA group with pain recurrence received repeat-RFA and had a secondary success. Mean operation time and dose of radiation exposure were lower in Robot-RFA group than that in CT-RFA group. The Robot-RFA group took fewer K-wire adjustment times for each patient than the CT-RFA group. There was a statistically significant difference in the mean operation time, dose of radiation exposure, and K-wire adjustment times between the groups (p < 0.05). No complications associated with the procedure were reported in the two groups during the follow-up period.ConclusionRobot-assisted RFA with O-arm navigation is a safer and more precise strategy in the treatment of osteoid osteoma with less operation time and radiation exposure compared with the conventional CT-guided radiofrequency ablation.

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Percutaneous radiofrequency ablation in osteoid osteoma: Tips and tricks in special scenarios

Cited by 19 publications

References 32 publications

Hand osteoid osteoma: evaluation of diagnosis and treatment

Hand osteoid osteoma: evaluation of diagnosis and treatment

Comparison of arthroscopy versus percutaneous radiofrequency thermal ablation for the management of intra- and juxta-articular elbow osteoid osteoma: case series and a literature review

O-Arm-Navigated, Robot-Assisted Versus Conventional CT Guided Radiofrequency Ablation in Treatment of Osteoid Osteoma: A Retrospective Cohort Study

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