Olecranon fossa osteoid osteoma excision through arthroscopy: surgical technique
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PROVIDER: S-EPMC10795925 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Osteoid osteoma (OO) is the most commonly seen benign bone-forming lesion. It can occur anywhere, including the metaphyseal regions of small and large bones. We present 2 cases that underwent an arthroscopic technique for removal of OO of the femoral neck. The diagnosis was confirmed by computed tomography in addition to magnetic resonance imaging. The lesions were accessed arthroscopically and excised by unroofing and curettage. The clinical and radiographic findings are presented, along with the surgical management. The patients improved dramatically postoperatively. OO of the femoral neck should be included in the differential diagnosis of hip pain in young patients. Arthroscopic excision and curettage provide a good choice for management, with low morbidity and rapid recovery.
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Project description:The fabella is an anatomic variant not seen in all individuals and can potentially be a source of chronic knee pain due to chondromalacia, osteoarthritis, fractures, or biomechanical pressure against the lateral femoral condyle. It is situated intra-articular, close to the lateral femoral condyle, the lateral gastrocnemius head tendon, and the fabellofibular ligament. Given its rarity, the diagnosis of a symptomatic fabella is often overlooked when evaluating patients with persistent posterolateral knee pain. However, this diagnosis should always be considered, especially in high-performance runners, bikers, and triathletes. Although nonoperative management can potentially resolve symptoms associated with this condition, fabella excision via arthroscopically assisted surgery is a reliable and safe alternative to treat patients who do not benefit from nonsurgical treatment. We present our technique detailing fabella excision for treatment of posterolateral knee pain, which includes an arthroscopic evaluation of the fabella to assess damage to the femoral condyle and minimize over-resection and potential damage to surrounding structures.
| S-EPMC5442983 | biostudies-literature
Project description:Osteoid osteoma has been reported infrequently around the elbow joint, and is usually treated with radiofrequency ablation or open excision. Elbow arthroscopy is useful for excision of accessible lesions, and the accompanying elbow stiffness can be treated concurrently. This report describes an arthroscopic excision of an osteoid osteoma located in the juxta-articular distal humeral bone. An initial adhesiolysis and capsulectomy is performed to gain access to the region above the capitellar articular margin. A 70° arthroscope is necessary to visualize this region via the anteromedial portal. An accessory lateral portal is used to detach the capsule from the distal humerus; the scar tissue overlying the lesion is debrided and the circumferential lesion is visualized and probed for identification of its extent. A biopsy is performed, and thereafter the lesion is excised piecemeal. The sclerotic margins are curetted, and radiofrequency ablation is performed. The technique is cosmetic and minimally invasive, and can be performed in revision scenarios involving recurrences after open surgery or needle radiofrequency thermal ablation. Early rehabilitation restores range of motion and strength. Technical tips for identification and curettage of the lesion are presented.
| S-EPMC5495153 | biostudies-literature
Project description:Osteoid osteoma is a benign tumor that can cause significant pain and disability. Excision of the tumor can be accomplished with open surgery or, as advocated in recent years, with computed tomography (CT)-guided radiofrequency ablation. In this article, a unique arthroscopic approach to excise an osteoid osteoma of the talus is presented. This was possible by relying on a clear intra-articular prominent osteophyte, which was used as a landmark to indicate tumor location in accordance with preoperative CT views. This technique enabled excision of the tumor with concomitant arthroscopic decompression of the osteophyte, which contributed to symptoms of anterior ankle impingement.
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Project description:Osteoid osteoma (OO) is a benign, solitary bone tumor of the long bones of the lower limbs and accounts for 10% to 12% of all benign bone. However, an OO of the femoral neck is extremely rare and difficult to treat. Arthroscopic excision of OO of the femoral neck has many advantages. We report a 15-year-old patient with OO of the femoral neck which was treated with arthroscopic excision. The clinical and radiographic findings along with the surgical management of the lesion are presented. The pain disappeared immediately after the operation. At the 14 months' followup, the patient was pain free, and there was no evidence of recurrence.
| S-EPMC6142806 | biostudies-literature
Project description:Osteoid osteoma is a benign osteoblastic tumor that occurs in the subcortical shaft and metaphysis of the long bones of the lower extremities; however, intra-articular lesions are also possible. Intra-articular osteoid osteomas are rare, and clinical symptoms are often less specific and, thereby, may lead to misdiagnosis. The definitive treatment for osteoid osteoma is the excision of the nidus. We present the case of a 23-year-old man with a 4-year history of right anterior hip pain, subsequently diagnosed with a subarticular osteoid osteoma located in the right anterior acetabulum. Hip arthroscopic excision of the juxta-articular osteoid osteoma is presented as an effective treatment, with the advantage of less potential damage to normal bone and cartilage, as well as the additional benefits available with hip arthroscopy.
| S-EPMC4454822 | biostudies-literature
Project description:Osteoid osteoma of the foot is a rare condition particularly of the calcaneum. This condition is difficult to diagnose and is more difficult to treat particularly if it involves deeper part of the joints. We present an arthroscopic technique to deal with a case of juxta-articular osteoid osteoma of the calcaneum using two portals: the anterolateral portal for instrumentation and the anterior anterolateral portal for visualization of the subtalar joint. Because this approach is minimally invasive, it offers early recovery and reduced morbidity compared with the conventional techniques.
| S-EPMC4810876 | biostudies-literature
Project description:Osteoid osteoma frequently requires surgical treatment, especially among young, active patients. However, surgeons are reluctant to perform open surgery for an osteoid osteoma of the femoral neck area because the conventional surgical approach requires a large incision in muscular patients, and percutaneous resection with a trephine has the attendant risk of subsequent fracture. Recently, arthroscopic excision of an osteoid osteoma has been reported as a less invasive, safer procedure than traditional open curettage. Hip arthroscopy using the burr-down technique under C-arm guidance to locate and remove the lesion of the femur neck has also shown promise. The presented technique minimizes muscle damage around the femur and enables surgeons to confirm complete resection of the lesion through direct, detailed visualization. Furthermore, early return to previous activity can be achieved after excising the lesion located at the calcar femorale, which is an area with a heavy weight-bearing load. The objective of this Technical Note was to describe our preferred technique for the surgical excision of osteoid osteoma located at the base of the femoral neck through the use of arthroscopy.
| S-EPMC5622304 | biostudies-literature
Project description: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 rim-based 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.
| S-EPMC5262517 | biostudies-literature
Project description:Osteoid osteoma (OO) of the coracoid is a rare entity that may present with variable symptoms from shoulder leading to delay in diagnosis and treatment. We present the clinical and radiological findings and management of one such case along with a review of similar cases reported in the literature. There was a delay of 2 years in diagnosis, which was later confirmed by computed tomography in addition to magnetic resonance imaging (MRI). The lesion was accessed arthroscopically and excised by unroofing and curettage. "OO" should be included in the differential diagnosis of shoulder pain in young patients not responding to long-term conservative treatment. Arthroscopic excision and curettage provide a good choice for management, with low morbidity and rapid recovery.
| S-EPMC4849236 | biostudies-literature