UNASSIGNED: To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.
UNASSIGNED: A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores ( P>0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.
UNASSIGNED: Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy ( P<0.05). There was no significant difference in lesion resection time ( P>0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value ( P<0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group ( P<0.05). However, there was no significant difference in VAS scores at 3 months between the two groups ( P>0.05).
UNASSIGNED: Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.
UNASSIGNED: 比较骨科机器人辅助微创手术与开放手术切除肢体骨样骨瘤的准确性与疗效。.
UNASSIGNED: 回顾分析2016年6月—2023年6月收治的36例肢体骨样骨瘤患者临床资料，其中16例选择骨科机器人辅助微创切除瘤巢手术（机器人手术组），20例采用常规C臂X线机透视定位后切除肿瘤（开放手术组）。两组患者性别、年龄、病灶部位、瘤巢直径以及术前疼痛视觉模拟评分（VAS）等基线资料比较，差异均无统计学意义（ P>0.05）。记录并比较两组手术时间、病灶切除时间、术中出血量、术中透视次数、病灶切除准确度、术后止痛药使用次数，以及术前及术后3 d、3个月疼痛程度（VAS评分）。.
UNASSIGNED: 与开放手术组相比，机器人手术组手术时间延长，但术中出血量、透视次数及术后止痛药使用次数均减少，病灶切除准确度提高，差异均有统计学意义（ P<0.05）；病灶切除时间差异无统计学意义（ P>0.05）。两组患者术后均获随访，随访时间均为3～24个月，中位时间均为12个月。术后两组均无切口感染、骨折等并发症发生。随访期间均无肿瘤复发。两组患者术后3 d、3个月时VAS 评分均较术前改善（ P<0.05）；术后3 d机器人手术组VAS评分较开放手术组更低（ P<0.05），但术后3个月VAS评分组间差异无统计学意义（ P>0.05）。.
UNASSIGNED: 与开放手术相比，骨科机器人辅助下切除肢体骨样骨瘤虽然手术时间延长，但病灶切除准确度提高、术中出血量减少、术后早期疼痛程度更轻，具有精准、微创优势。.

OBJECTIVE: Visfatin is currently a cytokine that is extensively researched in the field of bone diseases. In this prospective study, we aimed to investigate the potential of serum visfatin levels as a biomarker for the diagnosis of osteoid osteoma.
METHODS: This study included a cohort of 20 patients diagnosed with osteoid osteoma (Group 1) and 30 healthy individuals (Group 2). The age, gender, cyst sizes, and visfatin values of all participants were documented and analyzed.
RESULTS: There was a significant difference in visfatin levels between the two groups. The median visfatin level in Group 1 was 6.13 ng/ml (IQR: 4.21-8.08), while in Group 2, it was 15.83 ng/ml (IQR: 11.11-20.6). The difference was statistically significant (p<0.000). The optimal cut-off value for visfatin was found to be 7.74 ng/ml, which had a 93% sensitivity and 78% specificity.  An area under the curve of receiver operating characteristic (ROC) analysis of 0.85 indicates good diagnostic performance.
CONCLUSIONS: Our study revealed a significant decrease in visfatin levels among patients diagnosed with osteoid osteomas in comparison to the healthy control group. The ROC analysis revealed that visfatin exhibited a commendable diagnostic capacity, indicating its potential utility as a biomarker for osteoid osteoma.

Osteoid osteoma (OO) of the acetabulum is a quite rare pathology, with an overall incidence of 0,5%. Frequently the diagnosis of OO may not be simple to obtain, because the clinical presentation can mimic other common hip pathologies. We present a case report of OO of the anterior/superior edge of the acetabular fossa associated with a degenerative lesion of the acetabular labrum and with a concomitant femoral neck cam. The patient was refractory to prior pharmacological therapy with NSAIDs so arthroscopic treatment was performed. As a rational strategy, we trimmed the region of the tumor and we finally excised the nidus of the OO. Finally a femoroplasty and a partial labrectomy were performed. At the last follow-up the patient was symptom-free and able to walk with full weight bearing. The nocturnal pain was gone and his ROM improved fully without pain. The arthroscopic procedure, being less invasive, represents a valid option in the treatment of OO, allowing to treat radically the tumor and concurrently diagnose and repair any chondral or soft tissue injuries.

To study the effects of the control temperature, ablation time, and the background tissue surrounding the tumor on the size of the ablation zone on radiofrequency ablation (RFA) of osteoid osteoma (OO). Finite element models of non-cooled temperature-controlled RFA of typical OOs were developed to determine the resulting ablation radius at control temperatures of 70, 80, and 90°C. Three different geometries were used, mimicking common cases of OO. The ablation radius was obtained by using the Arrhenius equation to determine cell viability. Ablation radii were larger for higher temperatures and also increased with time. All geometries and control temperatures tested had ablation radii larger than the tumor. The ablation radius developed rapidly in the first few minutes for all geometries and control temperatures tested, developing slowly towards the end of the ablation. Resistive heating and the temperature distribution showed differences depending on background tissue properties, resulting in differences in the ablation radius on each geometry. The ablation radius has a clear dependency not only on the properties of the tumor but also on the background tissue. Lower background tissue\'s electrical conductivity and blood perfusion rates seem to result in larger ablation zones. The differences observed between the different geometries suggest the need for patient-specific planning, as the anatomical variations could cause significantly different outcomes where models like the one here presented could help to guarantee safe and successful tumor ablations.

To assess the safety and efficacy of computed tomography-guided radiofrequency (RF) ablation and magnetic resonance-guided focused ultrasound (MRgFUS) in the treatment of osteoid osteoma with a long-term follow-up study.
Database research was performed at 2 different centers with experience in musculoskeletal interventions. Both centers, one performing RF ablation and the other MRgFUS, identified 116 patients who underwent either RF ablation or MRgFUS procedures for the treatment of symptomatic osteoid osteoma and retrospectively evaluated data regarding pain scores using a visual analog scale (VAS). Complications were recorded according to the Cardiovascular and Interventional Radiological Society of Europe classification system. Propensity score matching for multiple variables was performed. Pain scores before and after therapy were compared.
Of 116 patients treated, 61 and 55 underwent RF ablation and MRgFUS, respectively. Before treatment, the mean reported pain in the 2 groups were 9.1 ± 0.88 (RF ablation) and 8.7 ± 0.73 (MRgFUS) VAS units. After treatment, a statistically significant (P < .00001) overall reduction in pain symptomatology was recorded. No statistically significant difference was observed between the mean values of pain after treatment in both groups (P = .256). Over a mean of >2 years of follow-up, 4 cases of relapse (RF ablation, 1; MRgFUS, 3) and 1 complication (RF ablation) were observed. The analysis from propensity score matching that identified a matched cohort of 48 patients showed similar results.
The 2 techniques for the treatment of osteoid osteoma resulted in profound and similar pain relief. The presence of thick cortical bone over the nidus can reduce the effectiveness of MRgFUS.

Osteoid osteomas are benign and nonprogressive lesions. The clinical presentation of osteoid osteoma is typical with night pain responsive to nonsteroidal anti-inflammatory agents. The typical radiological appearance is lucent nidus and adjacent reactive sclerosis. The most traditional management of osteoid osteoma is surgical removal which is associated with significant morbidity. This article aims to demonstrate our single-center experience of 55 patients with osteoid osteoma treated with percutaneous radiofrequency ablation (RFA).
Fifty-five symptomatic patients who were seen at our orthopedics outpatient clinics, diagnosed with osteoid osteoma, and referred to interventional radiology department between May 2015 and April 2019 were enrolled. The nidus size, pain numeric rating scale score, and intramedullary edema diameter before and after RFA were compared. Clinical and technical success, intervention-related complications, and need for subsequent ablation were recorded.
Of the 55 patients, including 12 pediatric cases, 6 had atypical locations such as metatarsal, vertebra, and scapula, while 1 case had osteoid osteoma with multiple nidus. The mean age was 18.5 ± 9.6 years. Preintervention maximum nidus diameter, pain score, and edema diameter were significantly lower in postintervention measurements (p < 0.001). Technical success rate was 98.1%, and clinical success was 96.36%. Severe complication occurred in one patient with soft tissue burn and osteomyelitis.
This is one of the largest series of osteoid osteoma treated with RFA done in a single center with atypical cases. In conclusion, RFA is safe and effective in both pediatric and adult patients with rare complications even in challenging cases with atypical locations.

OBJECTIVE: To evaluate technical success and long-term outcome of CT-guided radiofrequency ablation (RFA) of spinal osteoid osteomas (OO) and osteoblastomas (OB) in six different European centres.
METHODS: Eighty-seven patients with spinal OO (77) or OB (10) were treated with CT-guided RFA, after three-dimensional CT-guided access planning. Patient\'s long-term outcome was assessed by clinical examination and questionnaire-based evaluation including 10-point visual analogue scales (VAS) regarding the effect of RFA on severity of pain and limitations of daily activities. Clinical success was defined as a reduction of > 30% in the VAS score and patient\'s satisfaction.
RESULTS: Overall, RFA was technically successful in 82/87 cases (94.3%) with no major complications; clinical success was achieved in 78/87 cases (89.7%). The OO/OB were localized in the cervical (n = 9/3), the thoracic (n = 27/1), the lumbar (n = 29/4), and the sacral spine (n = 12/2). A decrease in severity of pain after RFA was observed in 86/87 patients (98.9%) with a persistent mean reduction of overall pain score from 8.04 ± 0.96 to 1.46 ± 1.95 (p < 0.001) after a median follow-up time of 29.35 ± 35.59 months. VAS scores significantly decreased for limitations of both daily (5.70 ± 2.73 to 0.67 ± 1.61, p < 0.001) and sports activities (6.40 ± 2.58 to 0.67 ± 1.61, p < 0.001).
CONCLUSIONS: In a multicentric setting, this trial proves RFA to be a safe and efficient method to treat spinal OO/OB and should be regarded as first-line therapy after interdisciplinary case discussion.

OBJECTIVE: This prospective phase I trial was conducted to evaluate the safety of percutaneous cryoablation for osteoid osteoma (OO).
METHODS: Nine patients with OO (mean tumor size: 5.9 mm; tibia, n = 5; femur, n = 2; lumbar spine, n = 2) were enrolled and treated with percutaneous cryoablation. The primary endpoint was the evaluation of the treatment safety as determined using step-by-step registration. The secondary endpoints were the incidence and grade of adverse events by CTCAE version 4.0, and the short-term efficacy of this treatment. Based on a decrease in the numerical rating scale (NRS) score, efficacy was classified as significantly effective (SE ≥ 5 or reached 0-2), moderately effective (ME 2-4), or not effective (NE < 2 or increase).
RESULTS: Cryoablation procedures were completed in all patients. Major adverse events (≥ grade 3) related to the procedure were not observed. Minor adverse events (≤ grade2) were observed in 22-67%. The mean NRS score was 7 before treatment, 0.6 at 4-week, 0.1 at 6-month, and 0 at 1-year post-treatment. All procedures were classified as SE.
CONCLUSIONS: Percutaneous cryoablation is a safe treatment for OO. Future phase II trials with large patient cohorts are warranted.

暂无摘要。

OBJECTIVE: To assess the efficacy of bisphosphonate therapy on bone pain in patients with osteoid osteoma (OO) (main objective), and to describe bisphosphonate-induced changes in nidus mineralisation and regional bone-marrow oedema (BMO).
METHODS: A prospective, observational study was conducted from 2011 to 2014. Patients with risk factors for complications of percutaneous or surgical ablation or recurrence after ablation, were offered once monthly intravenous bisphosphonate treatment until significant pain alleviation was achieved.
RESULTS: We included 23 patients. The first two patients received pamidronate and the next 21 zoledronic acid (mean, 2.95 infusions per patient). Bisphosphonate therapy was successful in 19 patients (83%), whose mean pain visual analogue scale score decreased by 76.7%; this pain-relieving effect persisted in 17 patients (74%) with a mean follow-up time of 36 months. Computed tomography (CT) demonstrated a mean nidus density increase of 177.7% (p = 0.001). By magnetic resonance imaging (MRI), mean decreases were 38.4% for BMO surface area and 30.3% for signal intensity (p = 0.001 and p = 0.000, respectively).
CONCLUSIONS: In 17/23 patients with painful OO managed conservatively with bisphosphonates, long-term final success was achieved. Bisphosphonates may accelerate the spontaneous healing of OO.
CONCLUSIONS: • 19/23 patients with OO managed with bisphosphonates experienced significant pain relief • Pain relief was sustained in 17/23 patients, mean follow-up of 36 months • CT demonstrated a significant increase in nidus mineralisation • MRI demonstrated a significant decrease in bone marrow oedema • Bisphosphonate therapy may accelerate the spontaneous healing of OO.