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      En bloc arthroscopic resection of osteoid osteoma in the hip: a report of four patients and literature review :

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          Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment.

          Osteoid osteoma, a benign bone tumor, has traditionally been treated with operative excision. A recently developed method for percutaneous ablation of the tumor has been proposed as an alternative to operative treatment. The relative outcomes of the two approaches to treatment have not previously been compared, to our knowledge. The rates of recurrence and of persistent symptoms were compared in a consecutive series of eighty-seven patients who were managed with operative excision and thirty-eight patients who were managed with percutaneous ablation with radiofrequency. Patients who had a spinal lesion were excluded. The minimum duration of follow-up was two years. There was a recurrence, defined as the need for subsequent intervention, after operative treatment in six (9 per cent) of sixty-eight patients who had been managed for a primary lesion and in two of nineteen who had been managed for a recurrent lesion. The average length of the hospital stay was 4.7 days for the patients who had a primary lesion and 5.1 days for those who had a recurrent lesion. There was a recurrence after percutaneous treatment in four (12 per cent) of thirty-three patients who had been managed for a primary lesion and in none of five who had been managed for a recurrent lesion. The average length of the hospital stay was 0.2 day for these thirty-eight patients. With the numbers available, we could detect no significant difference between the two treatments with regard to the rate of recurrence. The rate of persistent symptoms (that is, symptoms that did not necessitate additional treatment) was greater than the rate of recurrence. According to responses to a questionnaire, eight (30 per cent) of twenty-seven patients had persistent symptoms after operative treatment and six (23 per cent) of twenty-six patients had persistent symptoms after percutaneous treatment with radiofrequency. Two patients had complications after operative excision, necessitating a total of five additional operations. There were no complications associated with the percutaneous method. The results of the present study suggest that percutaneous ablation with radiofrequency is essentially equivalent to operative excision for the treatment of an osteoid osteoma in an extremity. The percutaneous method is preferred for the treatment of extraspinal osteoid osteoma because it generally does not necessitate hospitalization, it has not been associated with complications, and it is associated with a rapid convalescence.
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            Medical management compared with operative treatment for osteoid-osteoma.

            Twenty-four patients were evaluated and diagnosed, between August 1975 and July 1989, as having probable osteoid-osteoma. Fifteen patients had operative treatment (twelve immediate and three delayed); all fifteen had complete relief of pain. The remaining nine patients were treated with non-steroidal anti-inflammatory medications; all nine had complete relief of pain, and six had resolution of the symptoms without using non-steroidal anti-inflammatory drugs, after an average of thirty-three months (range, thirty to forty months) of treatment. Thus, long-term administration of non-steroidal anti-inflammatory drugs can often be as effective as excision for the treatment of osteoid-osteoma, without the morbidity that is associated with the operation, especially in patients in whom operative treatment would be complex or might lead to disability.
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              Hip arthroscopy utilizing the supine position.

              J Byrd (1994)
              The purpose of this article is to demonstrate the merits of the supine position in arthroscopic surgery about the hip. Twenty consecutive patients successfully underwent arthroscopy by this technique. The procedure is performed on a standard fracture table with fluoroscopy. Traction is used to distract the hip for introduction of the instruments. Three standard arthroscopic portals are routinely used. Two portals are placed laterally over the superior aspect of the greater trochanter, and one is placed anteriorly. The procedure is effective and reproducible. It is user friendly to both the surgeon and the operating room staff. Additionally, the procedure uses existing operating room equipment with only minor modifications.
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                Author and article information

                Journal
                Current Orthopaedic Practice
                Current Orthopaedic Practice
                Ovid Technologies (Wolters Kluwer Health)
                1940-7041
                2010
                May 2010
                : 21
                : 3
                : 320-326
                Article
                10.1097/BCO.0b013e3181c7ec09
                430d9a97-371c-481b-93aa-ec1461e28177
                © 2010
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