“Dry Arthroscopy” is a Valuable Tool in the Excisional Curettage of Chondroblastoma: A Case Series

Abstract

Introduction: Chondroblastomas are benign, locally aggressive bone tumors that occur in the epiphysis of young patients, requiring surgical excision. The anatomic locations of these lesions pose technical challenges to the surgeon; their proximity to the articular surface and the physis make surgical approach and visualization difficult. This case series describes the use of intramedullary arthroscopic assistance during excisional curettage of three distal femoral chondroblastomas. Case Report: Three patients with distal femoral chondroblastomas underwent excisional curettage with intraosseous “dry” arthroscopic assistance. We describe a two-tunnel technique, using medial and lateral windows so the arthroscope and working instruments could be within the lesion simultaneously; as well as a one-tunnel technique, where the arthroscope was inserted into the working tunnel once curettage was complete, to assess the excision. Conclusion: Achieving adequate exposure and visualization, while protecting the articular surface and physis, during excision of chondroblastomas, is essential for avoiding local recurrence and complications. “Dry” arthroscopic assistance provides the surgeon with an enhanced view of the tumor and tumor cavity, minimizes invasiveness, and has the potential to reduce complications without compromising the completeness of the excision. Keywords: Chondroblastoma, orthopedic oncology, arthroscopy, dry arthroscopy, bone tumor.

Does the intercondylar approach provide a better outcome for chondroblastoma of the distal femur in skeletally immature patients?

“…The distal femur is one of the most frequent sites for a chondroblastoma. 1 Several options are available for the treatment of distal femur chondroblastoma, including dry arthroscopy, 2 radiofrequency ablation, 3 and cryotherapy. 4 However, intralesional curettage and bone grafting with or without local adjuvants is the treatment of choice.…”