Intraoperative radiofrequency ablation for osteoid osteoma

Percutaneous radiofrequency ablation (RFA) has been increasingly used in the treatment of osteoid osteoma (OO), as this method has provided satisfactory results with minimal morbidity. RFA traditionally has been performed by radiologists under computed tomography (CT) guidance. Advances in intraoperative imaging techniques now allow orthopedic oncologists to perform image-guided RFA in the operating room. We conducted a study to evaluate the efficacy of a novel technique that uses intraoperative CT-guided RFA to treat OO. We reviewed 28 consecutive cases of OO treated with intraoperative RFA by a single surgeon between September 2004 and December 2008. Primary or secondary success was defined as complete pain relief without evidence of recurrence after the first or second procedure, respectively. Failure was defined as the continued presence of symptoms combined with radiographic evidence of recurrence. Primary success rate was 92.8%. Two patients had a recurrence and underwent a successful second RFA. Our success rates are similar to those in the radiology literature. Further studies are needed to validate the efficacy of this novel technique.