Abstract
Osteoid osteomas are benign, painful osteogenic tumours of small size (≤ 1,5 cm). Surgical resection of the nidus has been the elected method of treatment for decades but some complications and difficulties (poor localization, extensive tissue damage, fractures, delayed recovery) encouraged the development of less invasive techniques such as radiofrequency.
Lack of histological proof is the major concern regarding radiofrequency ablation as we make the diagnosis by the clinical findings and the image features.
We present the results of 20 patients with osteoid osteoma treated with radiofrequency from January 2004 to December 2008 (mean follow up 23 months). All patients were under general anaesthesia and de access route was chosen in the CT-suite. 11 cases were located in the proximal femur (head, neck and subtrocanteric region), 2 in the distal femur, 2 in de distal humerus, 2 in the tibia, 2 in the acetabulum, and 1 in de vertebal body of D8.
In all cases we used a Cool-tip TM RF electrode (water-cooled tip) reaching a heating temperature of 42°C to 48°C during 12 minutes. In 7 patients a cannulated drill bit was used to penetrate the thick cortical or to reach the nidus through the opposite side in order to avoid a neurovascular bundle.
Hospital discharge was allowed after 6 to 8 hours after the procedure.
No complications occurred.
All patients, except one, experienced complete relief of the pain although the 6-month follow-up CT’s do not show sclerosis of the nidus. None of them recurred till data. The patient who did not recover had not had a clear diagnosis.
We conclude that radiofrequency ablation is effective, safe, favouring rapid recovery and, of course, reduces economical and social costs.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
