Hip arthroscopy for the management of osteoid osteoma of the acetabulum: a systematic review of the literature and case report.
BACKGROUND
Intra-articular osteoid osteoma (OO) causes irreversible joint damage. Its treatment of choice is radiofrequency ablation (RFA); however, some areas of the acetabulum are hard to access. Therefore, hip arthroscopy was used to treat this tumor. We aim to systematically review the literature with regards to arthroscopic management of acetabular OO, and to report a further case in which hip arthroscopy was used for treatment.


METHODS
PubMed and EMBASE were searched for articles relevant to the arthroscopic management of acetabular OO on December 2, 2014. All articles published on and before that date were reviewed, and studies which met our pre-determined inclusion criteria were included. Articles screening and data abstraction were done by two reviewers independently. We also presented a 31-year-old man with acetabular OO who underwent hip arthroscopy for the management of his tumor after failing to respond to medications and computed tomography scan (CT)-guided RFA.


RESULTS
The initial search revealed 14 studies, of which ten met our inclusion criteria. A total of ten patients underwent hip arthroscopy for the management of acetabular OO. Only two patients were females, and the patients' age ranged from 7 to 47 years. Two patients underwent arthroscopic guided-RFA of the lesion, while the rest underwent excision. The follow-up period ranged from 6 months to 2 years. Success rate was 100 %, and no recurrence was reported. Minor complications (transient impotence and perineal numbness) developed in one patient (10 %). Arthroscopic-guided RFA failed to eliminate the tumor in our additional case. A second trial of CT-guided RFA was successful in treating the patient's condition.


CONCLUSIONS
Hip arthroscopy is an effective and safe option for the management of acetabular OO, with success rate exceeding 90 %. Studies of higher level of evidence are required.
Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait. yousefmarwan@hotmail.com.|Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada. yousefmarwan@hotmail.com.
Yousef A
YA
Marwan
Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada. sarantisio@gmail.com.
Sarantis
S
Abatzoglou
Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait. ali.esmaeel@gmail.com.|Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait. ali.esmaeel@gmail.com.
Ali A
AA
Esmaeel
Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada. dr.saad91@gmail.com.|Department of Orthopaedic Surgery, University of Dammam, Dammam, Saudi Arabia. dr.saad91@gmail.com.
Saad M
SM
Alqahtani
Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada. alsulaimani@ymail.com.
Saleh A
SA
Alsulaimani
Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada. michael.tanzer@mcgill.ca.
Michael
M
Tanzer
Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada. robert.turcotte@muhc.mcgill.ca.
Robert E
RE
Turcotte
D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D001182:Arthroscopy; D001859:Bone Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D010017:Osteoma, Osteoid / Q000601:surgery*