title: Computed tomography-guided and arthroscopically controlled en bloc retrograde resection of a juxta-articular osteoid osteoma of the tibial plateau.
abstract: Osteoid osteoma represents approximately 10% to 11% of all the benign bone tumors. The localization at the articular and juxta-articular level of the knee is an atypical picture that causes both diagnostic and therapeutic problems. We present the case of an osteoid osteoma of the lateral tibial plateau just beneath the joint level. The lesion was removed by a rear-entry computed tomography (CT)-guided drill under arthroscopic control and the bony defect filled with bone graft harvested from the proximal tibial metaphysis. Postoperative CT scans at 3 months, and 1 and 2 years were performed. The result of the kneeling test to evaluate donor-site morbidity 1 year after the surgery was negative. There were no immediate or delayed complications. Currently (2 years postoperatively), the patient has no pain and has gone back to his normal active daily lifestyle and routines. The follow-up CT scan 2 years after surgery showed complete excision of the lesion and perfect positioning of the bone graft. This new approach/technique enabled us to avoid damaging the proximal structures, to examine the lesion, and to fill the bony defect. Moreover, as shown by CT scan at follow-up, iatrogenic lesions to the cartilage of the tibial plateau were not reported.
authors.affiliation: Department of Orthopaedics and Traumatology, School of Medicine and Surgery, Università Campus Bio-Medico, Rome, Italy. f.franceschi@unicampus.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.forename: Andrea
authors.initials: A
authors.lastname: Marinozzi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Rizzello
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.forename: Mario
authors.initials: M
authors.lastname: Rojas
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000209:etiology; D001182:Arthroscopy / Q000379:methods*; D001859:Bone Neoplasms / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D010017:Osteoma, Osteoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D016059:Range of Motion, Articular; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome