Comparison of arthroscopy versus percutaneous radiofrequency thermal ablation for the management of intra- and juxta-articular elbow osteoid osteoma: case series and a literature review

Abstract

Background Today, intra-articular and juxta-articular osteoid osteomas are treated with arthroscopy and radiofrequency thermal ablation. However, for the case of an elbow joint, arguments are made for the use of a minimally invasive technique to be the optimal choice. This study aims to analyse our experiences of arthroscopically treated elbow osteoid osteomas and to compare it with the published results of both techniques. Methods The retrospective study analyses the patients who underwent elbow arthroscopy ablation of an elbow osteoid osteoma at a single institution from January 2014 until March 2020. Clinical and diagnostic features, success and treatment failure rates, complications and tumour recurrence rates were all compared to 13 studies of intra-articular elbow osteoid osteoma arthroscopic ablation and 15 studies involving radiofrequency thermal ablation of intra-articular osteoid osteoma within different joints. Results Four males and two females, with a mean age of 19.3 years, were encompassed. All the patients had immediate postoperative pain relief and improved range of motion. No tumour recurrences were observed during a median of 21.7 months. The literature review yielded 86.4% success rate, 68.2% successful biopsies, one minor complication and no recurrences following the arthroscopic ablation of an elbow osteoid osteoma; while radiofrequency thermal ablation of an intra-articular elbow osteoid osteoma yielded 96.3% success rate, 33.3% successful biopsies, no complications and 3.7% recurrence rate. Conclusions Our results are consistent with the published literature proving that arthroscopic ablation is an efficient method with low treatment failure rates and no recurrences in treating intra- and juxta-articular elbow osteoid osteomas. Advantages of arthroscopic ablation stem from the ability to visualise and safely deal with the lesion and the joint’s reactive changes resulting in high biopsy rates, no recurrences and better postoperative elbow’s range of motion. Still, the technique selection should be personalised considering the medical expertise of every institution.

Arthroscopic treatment of osteoid osteoma in the posterior proximal tibia: A case report and literature review

“…One year after surgery, all pain symptoms completely disappeared, and the right elbow range of motion increased to 30° to 145°. Knezevic et al [ 23 ] conducted a case-control analysis of patients with elbow joint OO, treated with arthroscopic radiofrequency ablation and percutaneous radiofrequency ablation under CT guidance by the same surgeon at the same institution over approximately 6 years. They stated that arthroscopy can precisely locate the lesion before radiofrequency ablation, collect samples for pathological biopsy, further confirm the tumor diagnosis, and minimize damage to the cartilage and surrounding soft tissues during the surgery.…”

“…This has been widely promoted in the field of orthopedics. [23,24] Alrassasi et al [25] conducted a case analysis of a 28-yearold female patient with OO of the right elbow. The patient had contracture of the right elbow, with a range of motion between 50° and 110°.…”

Intra‐articular Osteoid Osteoma of the Intermediate Cuneiform Bone Causing Articular Degeneration: A Rare Case and Literature Review

“…What is more, arthroscopy allows the handling of many other conditions simultaneously. Studies have demonstrated successful applications of arthroscopy in osteoid osteoma 28–31 . Interestingly, for intra‐ and juxta‐articular localization of osteoid osteoma, arthroscopy‐assisted radiofrequency ablation was proposed 31–33 .…”

“…Studies have demonstrated successful applications of arthroscopy in osteoid osteoma. 28 , 29 , 30 , 31 Interestingly, for intra‐ and juxta‐articular localization of osteoid osteoma, arthroscopy‐assisted radiofrequency ablation was proposed. 31 , 32 , 33 This technique synthesizes both of the strengths.…”

Intraoperative three-dimensional navigation for surgical treatment of osteoid osteoma in the upper extremity: A series of 19 cases

“…21 Knežević et al published their series (6 patients) and a review of the literature (23 patients) on OO involving the elbow with success rates of 86.4%-96.3%, minimal complication rates, and recurrence rates of 0%-3.7%. 30 Ge et al also published a review of 19 patients with OO of the elbow who underwent arthroscopic treatment. They reported good functional outcomes with 10.5% reoperations and 10.5% complications.…”