Abstract
Purpose
The aim of this study is to describe the procedure technique, clinical and imaging outcomes of patients treated with radiofrequency ablation for chondroblastoma.
Materials and methods
Four patients (female/male, 3:1; mean age, 13 years; age range; 9–16 years) underwent the procedure. All had pre-operative magnetic resonance imaging (MRI) and symptomatic, biopsy-proven chondroblastomas (two proximal femur, two proximal tibia). The lesion size ranged from 1.5 to 2.5 cm in maximal dimension (mean size, 1.8 cm). Bone access was gained with a Bonopty biopsy needle system (mean number of radiofrequency needle placements, 5; mean ablation time, 31 min).
Results
Clinical and MRI follow-up was available in all cases (mean, 12.25 months; range, 5–18 months). All patients reported resolution of symptoms at 2–6 weeks post ablation. At their most recent clinical follow-up, three patients remained completely asymptomatic with full return to normal activities and one patient had minor local discomfort (different pain pattern) that was not limiting activity. All four patients’ follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement.
Conclusion
Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances.
Similar content being viewed by others
References
Campanacci M. Bone and soft tissue tumours: clinical features, imaging, pathology and treatment, 2nd ed. New York: Springer; 1999. p. 247–264.
Resnick D. Diagnosis of bone and joint disorders, 4th ed. WB Saunders Company: Philadelphia; 2002. p. 3850–3866.
Stoller DW, Tirman PFJ, Bredella MA. Diagnostic imaging in orthopaedics. Salt Lake City: Amirsys; 2004. p. 26–28.
Rosenthal D, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183: 29–33.
Rosenthal D. Radiofrequency treatment. Orthop Clin N Am 2006; 37: 475–484.
Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency ablation of osteoid osteoma compared with operative treatment. J Bone Jt Surg Am 1998; 80: 815–821.
Erickson JK, Rosenthal DI, Zaleske DJ, Gebhardt MC, Cates JM. Primary treatment of chondroblastoma with percutaneous radiofrequency heat ablation: report of three cases. Radiology 2001; 221: 463–468.
Tins B, Cassar-Pullicino V, McCall I, Cool P, Williams D, Mangham D. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results. Eur Radiol 2006; 16: 804–810.
Van Der Geest IC, Van Noort MP, Schreuder HW, Pruszczynski M, De Rooy JW, Veth RP. The cryosurgical treatment of chondroblastoma of bone: long term oncologic and functional results. J Surg Oncol 2007; 96(3): 230–234.
Suneja R, Grimer RJ, Belthur M, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Jt Surg Br 2005; 87(7): 974–978.
Ramappa AJ, Lee FYI, Tang P, Carlson JR, Gebhardt MC, Mankin HJ. Chondroblastoma of bone. J Bone Jt Surg Am 2000; 82A: 1140–1145.
Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M. Chondroblastoma: a review of seventy cases. J Bone Jt Surg Am 1985; 67: 748–755.
Davis KW, Choi JJ, Blankenbaker DG. Radiofrequency ablation in the musculoskeletal system. Semin Roentgenol 2004; 39: 129–144.
Petsas T, Megas P, Papathanassiou Z. Radiofrequency ablation of two femoral head chondroblastomas. Eur J Radiol 2007; 63: 63–67.
Rybak LD, Rosenthal DI, Wittig J. Radiofrequency ablation of chondroblastomas: an alternative to surgical resection in selected cases. A presentation at RSNA 2007 (abstract).
Martel J, Bueno A, Dominguez MP, Llorens P, Quiros J, Delgado C. Percutaneous radiofrequency ablation: relationship between different probe types and procedure time on length and extent of osteonecrosis in dog long bones. Skeletal Radiol 2008; 37: 147–152.
Vanderscheuren GM, Taminiau AHM, Obermann WR, van den Berg-Huysmans AA, Bloem JL, van Erkel AR. The healing pattern of osteoid osteomas on computed tomography and magnetic resonance imaging after thermocoagulation. Skeletal Radiol 2007; 36: 813–821.
Lee MH, Ahn JM, Chung HW, et al. Osteoid osteoma treated with percutaneous radiofrequency ablation: MR imaging follow up. Eur J Radiol 2007; 64(2): 309–314.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Christie-Large, M., Evans, N., Davies, A.M. et al. Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases. Skeletal Radiol 37, 1011–1017 (2008). https://doi.org/10.1007/s00256-008-0526-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-008-0526-4