Radiofrequency ablation in the treatment of osteoid osteoma-5-year experience.
OBJECTIVE
This study aimed to determine the success and complication rates of radiofrequency ablation (RFA) in treatment of osteoid osteoma (OO) and duration of pain relief. Furthermore value of bone biopsy prior to the RFA was evaluated.


METHODS
Within 61 months 39 patients (23 male, 16 female, 7-53 years, mean 18.7 years, median 17 years) suffering from osteoid osteoma were treated. Lesions were located in femur (n=20), tibia (n=10), spine (n=5), humerus (n=1), radius (n=1), talus (n=1) and pelvis (n=1). In children, RFA was performed under general anaesthesia, in adults conscious sedation was preferred. In 29 of 39 (74%) lesion biopsies were obtained. Cooling of skin was performed in OOs located in bones with minor soft tissue covering (tibia, radius) and saline flushing via an additional needle was performed if the OO was adjacent to nerval structures. Primary success rate, complications, symptom-free interval, follow-up and biopsy results were evaluated.


RESULTS
Within observation period (1-61 months; median: 32 months) 38 of 39 patients were successfully treated and had no more complaints. In 3 of 38 patients relapse occurred after 1, 14 and 32 months and RFA was repeated. Two major complications (broken drill, infection) and 2 minor complications (hematoma, prolonged pain) were observed. Biopsy was able to prove diagnosis in 14 of 29 (48%) cases.


CONCLUSIONS
Biopsy prior to treatment is not mandatory due to a remarkable amount of false negative findings in clinically and morphologically unambiguous cases of OO. RFA is a highly effective, efficient, minimally invasive and safe method for the treatment of OO.
Hoffmann
Ralf-Thorsten
RT
Institute of Clinical Radiology, Ludwig Maximilians-University, Campus Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. rthoffma@med.uni-muenchen.de
Jakobs
Tobias F
TF
Kubisch
Constanze H
CH
Trumm
Christoph G
CG
Weber
Christof
C
Duerr
Hans-Roland
HR
Helmberger
Thomas K
TK
Reiser
Maximilian F
MF
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult