Hip Arthroscopy for Removal of an Acetabular Rim–Based Osteoid Osteoma and Concomitant Femoroacetabular Impingement Correction

Abstract

Minimally invasive percutaneous radiofrequency ablation (RFA) techniques are the standard of care for treating simple osteoid osteomas (OOs). Historically, OOs were treated with open en bloc resection or curettage of the nidus. RFA procedures have been linked to soft-tissue complications of varying severity. In addition, RFA may be a poor choice for periarticular OOs because of the potential for procedure-related articular cartilage damage. Hip arthroscopy is a widely accepted approach for the treatment of femoroacetabular impingement. We describe arthroscopic resection of an acetabular rimebased OO as part of a rim resection and labral repair. Early clinical follow-up suggests that arthroscopic resection of an OO in this unusual location is precise and predictable, allows for an additional evaluation of associated symptomatic pathology (i.e., femoroacetabular impingement), and results in prompt symptom resolution.

Cartilage-Preserving Arthroscopic-Assisted Radiofrequency Ablation of Periacetabular Osteoid Osteoma in a Young Adult Hip

“…OOs around the acetabulum can often border the cortical bone-subchondral interface, making ablation challenging. Three technique case reports 7 , 8 , 9 used arthroscopic-assisted radiofrequency ablation of lesions; however, what differentiates the technique used in our case is the preservation of the acetabular cartilage and subsequent filling of the lesion with bone graft substitute.…”

Arthroscopic removal of osteoid osteoma with gamma probe assistance in the hip joint

“…1,6 Several case reports on arthroscopic removal of osteoid osteomas from the hip joint have been published to-date. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] A 70-degree scope, curved instruments and fluoroscopic control enable a nidus located in various parts of the peripheral and central compartment of the hip joint to be reached and removed, with the posteroinferior part of the acetabulum reported to be most challenging. 21,25 To the best of our knowledge, our case series of arthroscopically treated osteoid osteoma of the hip is the second largest reported to-date.…”

“…[13][14][15][16][17] However, there have been an increasing number of reports regarding arthroscopic treatment of articular cases, including in the hip joint. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Surgical treatment of osteoid osteoma may be associated with incomplete or excessive removal of the bone involved. The gamma probe has been introduced to prevent this concern during open excision or CT guided percutaneous ablation of the nidus.…”

Minimally invasive CT-guided excision of osteoid osteoma and other small benign bone tumours: a single centre case series in South Africa

“…The use of this technique has been described in the hip (both femoral and acetabular sided lesions), knee, shoulder, ankle and talus. [12][13][14][15] Proposed advantages are the minimally invasive surgical approach and limited articular injury when compared with RFA and open surgical excision. However, arthroscopic surgery is technically demanding and has a prolonged learning curve.…”

“…8 Novel techniques such as magnetic resonanceguided focused ultrasound (MRgFUS) [9][10][11] and arthroscopic excision are also currently being evaluated. [12][13][14][15] While the use of novel techniques to deal with small benign bone tumours is becoming ever more popular, the additional time and cost are not yet justified by better patient outcomes. 16 At our centre, computer tomography (CT) guided percutaneous curettage and bone grafting is performed as this method has a high success rate, a low number of complications, and provides a histological diagnosis without the need for costly additional equipment.…”