Resection of Femoral Head–Neck Junction Osteoid Osteoma via Minimally Invasive Direct Anterior Approach: A Case Series and Review of Literature

Abstract

Our aim was to introduce a new minimally invasive approach for surgical excision of femoral head–neck junction osteoid osteoma (FHNJOO) and review the available literature regarding its clinical manifestations and treatment methods. We included nine patients with FHNJOO in this series, who underwent resection via the minimally invasive direct anterior approach (DAA), from January 2010 to 2013. The functional outcomes were hip range of motion (ROM), visual analogue scale for pain (VAS), and Harris hip score (HHS), which were assessed pre- and postoperatively at 3 months at the last follow-up. We had nine patients with a mean age of 17.25 ± 6.75 years. The mean diagnosis delay was 23.56 ± 4.67 months. We had a mean follow-up of 93.67 ± 18.02 months. The hip ROM, VAS, and HHS were significantly improved from 97.78 ± 8.70 degrees to 121.11 ± 4.86 degrees, 63.93 ± 10.47 to 99.11 ± 1.76 degrees, and 7.3 ± 1.5 to 0.1 ± 0.3 degrees at 3-month and the last follow-up, respectively (p < 0.001). We observed no recurrence or complications. The minimally invasive DAA approach for surgical resection of FHNJOO can provide immediate pain relief and improve hip functional scores with no complication or recurrence on long-term follow-up. It provides easy and complete access to the lesion and causes no morbidity due to minimal dissection.