title: Radiofrequency ablation in the treatment of cartilaginous lesions in the long bones: results of a pilot study.
abstract: Atypical cartilaginous tumours are usually treated by curettage. The purpose of this study was to show that radiofrequency ablation was an effective alternative treatment. We enrolled 20 patients (two male, 18 female, mean age 56 years (36 to 72) in a proof-of-principle study. After inclusion, biopsy and radiofrequency ablation were performed, followed three months later by curettage and adjuvant phenolisation. The primary endpoint was the proportional necrosis in the retrieved material. Secondary endpoints were correlation with the findings on gadolinium enhanced MRI, functional outcome and complications. Our results show that 95% to 100% necrosis was obtained in 14 of the 20 patients. MRI had a 91% sensitivity and 67% specificity for detecting residual tumour after curettage. The mean functional outcome (MSTS) score six weeks after radiofrequency ablation was 27.1 (23 to 30) compared with 18.1 (12 to 25) after curettage (p < 0.001). No complications occurred after ablation, while two patients developed a pathological fracture after curettage. We have shown that radiofrequency ablation is capable of completely eradicating cartilaginous tumour cells in selective cases. MRI has a 91% sensitivity for detecting any residual tumour. Radiofrequency ablation can be performed on an outpatient basis allowing a rapid return to normal activities. If it can be made more effective, it has the potential to provide better local control, while improving functional outcome.
authors.affiliation: University Medical Center Groningen, Department of Orthopaedic Surgery Postbus 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: E F
authors.initials: EF
authors.lastname: Dierselhuis
authors.affiliation: University Medical Center Groningen, Department of Radiology, Postbus 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: P J M
authors.initials: PJ
authors.lastname: van den Eerden
authors.affiliation: University Medical Center Groningen, Department of Surgery, Postbus 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
authors.affiliation: University Medical Center Groningen, Department of Orthopaedic Surgery, Postbus 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: S K
authors.initials: SK
authors.lastname: Bulstra
authors.affiliation: University Medical Center Groningen, Department of Pathology, Postbus 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: A J H
authors.initials: AJ
authors.lastname: Suurmeijer
authors.affiliation: University Medical Center Groningen, Department of Orthopaedic Surgery, Postbus 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: P C
authors.initials: PC
authors.lastname: Jutte
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002356:Cartilage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Atypical cartilaginous tumour; Chondrosarcoma; Minimal invasive; Radiofrequency ablation