title: Treatment of osteoid osteoma of the elbow by radiofrequency thermal ablation.
abstract: BACKGROUND
  This article presents the experience at the Rizzoli Orthopaedic Institute in the treatment of intracapsular osteoid osteoma (OO) of the elbow by computed tomography-guided percutaneous radiofrequency thermal ablation (RFA).
  
  
  METHODS
  Our team performed more than 800 RFA procedures to treat OO up to 2010. In 27 cases, the lesion site was the articular area of the elbow (humerus in 13 cases, ulna in 13, and radius in 1). These patients were reviewed and assessed for eradication rate, incidence of complications, and functional results measured by the Mayo Elbow Performance Score. The outcome was evaluated after a mean follow-up period of 67.4 ± 35.3 months (range, 24-128 months).
  
  
  RESULTS
  The mean duration of symptoms at the time of diagnosis was 31.0 ± 19.8 months (range, 5-72 months). All patients complained about pain, and in 24 of 27 cases (88.8%), the joint function was significantly impaired by the presence of OO (pretreatment score, 54.8). After RFA, the Mayo Elbow Performance Score improved by a mean of 37.7 ± 14.8 points, with 25 of 27 patients (92.5%) scoring 90 to 100 points at final follow-up. OO recurred in only 1 patient (3.7%), 5 months after the procedure. However, this was successfully retreated by RFA. No adverse effects were observed, and all patients were free of disease at the final follow-up.
  
  
  CONCLUSIONS
  The RFA procedure can be technically challenging in difficult sites such as the elbow joint. The low invasiveness of RFA compared with traditional surgery allows excellent functional recovery. RFA of elbow OO is effective and safe, and it should be considered the first-choice treatment for this disease.
authors: Diagnostic and Interventional Radiology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors: Ugo
authors: U
authors: Albisinni
authors: Diagnostic and Interventional Radiology, Rizzoli Orthopaedic Institute, Bologna, Italy; Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors: Alberto
authors: A
authors: Bazzocchi
authors: Shoulder and Elbow Surgery Unit, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors: Graziano
authors: G
authors: Bettelli
authors: Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors: Giancarlo
authors: G
authors: Facchini
authors: Shoulder and Elbow Surgery Unit, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors: Emanuela
authors: E
authors: Castiello
authors: Shoulder and Elbow Surgery Unit, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors: Michele
authors: M
authors: Cavaciocchi
authors: Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors: Giuseppe
authors: G
authors: Battista
authors: Shoulder and Elbow Surgery Unit, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: roberto.rotini@ior.it.
authors: Roberto
authors: R
authors: Rotini
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D004550:Elbow; D005260:Female; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000601:surgery*; D011884:Radius / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014457:Ulna / Q000601:surgery; D055815:Young Adult
keywords: Case Series; Level IV; Osteoid osteoma; RFA; Treatment Study; benign bone lesion; elbow; elbow pain; treatment efficacy