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Osteoid Osteoma: CT-Guided Radiofrequency Ablation Using a Water-Cooled Probe

¹ Department of Orthopaedic Surgery, The Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel
² Department of Radiology, The Hadassah-Hebrew University Medical Center, Jerusalem, Israel

Correspondence: Address correspondence and reprint requests to: A. Peyser, MD; E-mail: peysera{at}hadassah.org.il

Background: The purpose of this study was to assess the safety and efficacy of computed tomography (CT) guided percutaneous radiofrequency (RF) ablation of osteoid osteoma by using the water-cooled probe.

Methods: During the period from July 2002 to February 2006, fifty-one patients with osteoid osteomas localized in femur (29), tibia (10), calcaneus (2), talus (2), metatarsus (2), humerus (1), sacrum (1), scapula (1), olecranon (1), patella (1) and thoracic vertebra (1) were treated with CT-guided RF ablation using the Cooltip^TM Tyco Healthcare probe. Mean age was 20 (range, 3.5–57 years) and male to female ratio was 36/15. Mean follow-up period was reported 2 years (range, 9–51 months). The procedures were carried out under general anesthesia and the patients were discharged from the hospital within 24 h.

Results: Technical failure was reported in only one procedure. Pain disappeared postoperatively in all the patients within 2–3 days and no patients needed analgesic treatment after a week. All patients were allowed fully weight bear and function without limitation after the procedure. Recurrence of the pain was observed in one patient who was treated successfully with a second ablation. Our primary and secondary clinical success rates were 98 and 100% respectively. In one case, wound infection was observed after the procedure as the only postoperative complication in our series.

Conclusion: CT-guided percutaneous RF ablation of osteoid osteomas using the water-cooled probe is a safe, effective and minimally invasive procedure with high success rate and lack of relapses.

Key Words: Osteoid osteoma • CT • Radiofrequency ablation • Water-cooled probe