Abstract
Purpose: Chondroblastomas are a lesion of immature cartilage found in a typically epiphyseal location. The peak incidence is in teenagers. Current surgical treatment is a balance between complete excision, with potential for physeal and articular cartilage damage, and local recurrence. A minimally invasive technique with a low complication rate providing effective treatment may be provided by radiofrequency (RF) thermocoagulation. Already the treatment of choice for Osteoid Osteoma – another lesion that can occur in the epiphysis.1,2,3 Literature to date on clinical use of RF thermocoagulation in chondroblastoma is scarce.4 The high water content of chondroblastoma should ensure its sensitivity to RF ablation. Our units experience in osteoid osteoma has been extended to RF thermocoagulation of chondroblastoma.
Patients: Four patients were treated with RF thermocoagulation for a chondroblastoma. Minimum follow up one year.
Methods: A RITA Starburst probe thermocoagulates the lesion for at least 5 minutes at 90 degrees centigrade. Overnight stay and outpatient follow up until skeletal mature, or two years following treatment.
Results: Two chondroblastomas were in the proximal tibia, one in the distal femur and one in the proximal humerus. One patient had surgery previously and one patient presented with collapse of the proximal tibial plateau. All patients were treated successfully and are pain free. All patients, accepting the one with pre-existing collapse, have a full range of movement. There has been no local recurrence at one year.
Conclusion & Discussion: Our experience suggests that radiofrequency thermocoagulation is a safe and effective treatment method for patients with chondroblastoma.
Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
References:
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