The clinical applications of CT-guided percutaneous microwave ablation of hip osteoid osteoma

Abstract

：Objective To evaluatethe clinical effectiveness of the treatment for hip osteoid osteoma by CT-guidedpercutaneous microwave ablation. Methods From August 2006 to January 2010, 8 patients withthe osteoid osteomas of the hip were treated with CT-guided percutaneous microwaveablation, including 5 males and 3 females with an average age of 18.8 years (range, 12 to25). The history of local pain was ranging from 2 months to 10 years, with aggravation ofpain at night. The locations of the lesions contained: 4cases in the neck of femur, 2 inthe lesser trochanter, 1 in the greater trochanter and 1 in the femoral intertrochantericline. After localization of the nidus with CT, osseous access was established with aGallini puncturatio needle. After scanning the nidus with CT, a trocar was used to obtainspecimens for pathological examination. Subsequently, a microwave probe was introducedthrough the biopsy needle to the nidus. Microwave ablation was performed at 90 ℃ for 4 to 6 minutes. Prophylacticantibiotics were used two days postoperatively. Results Three patients were diagnosed asosteoid osteoma with the pathological confirmation after the operation, 5 cases were notdiagnosed by the pathological confirmation. All the cases were followed up for 6 to 21months. All the patients reported alleviated pain in the first 24 hours postoperation. Onecase with lesion in the right proximate femur retained mild pain without nonsteroidalantiinflammatory drugs 5 month after operation. The same procedure was done once more onthis patient, and the outcome was good. No osteonecrosis of the femoral head and othercomplications were observed in all patients. Conclusion By CT-guided percutaneousmicrowave ablation for osteoid osteomas of hip reliably relieves pain with fewcomplications and recurrences. The short-term efficacy is satisfactory. It is a safe andeffective technique for treatment of osteoid osteoma.[ Key words ] Hip joint; Osteoma,osteoid; Microwaves; Catheter ablation Key words: Hip joint; Osteoma, osteoid; Microwaves; Catheter ablation