Paper #64 - ISHA Annual Scientific Meeting 2016

Gamma-Probe Assisted Arthroscopic Removal of Osteoid Osteoma in the Hip Joint - Long Term Results

Klemen Stražar, MD, PhD, Ljubljana SLOVENIA
Ivan Slodnjak, Ljubljana SLOVENIA
Oskar Zupanc, PhD, Ljubljana SLOVENIA
Matej Drobnic, PhD, Ljubljana SLOVENIA

University Medical Centre Ljubljana, Ljubljana, SLOVENIA

FDA Status Not Applicable

Summary: The purpose of the paper is to present the surgical technique and long-term clinical outcome in a series of patients treated with gamma-probe assisted arthroscopic removal of osteoid osteoma in the hip joint.

Abstract:
Purpose: The aim of this paper is to present long-term clinical results of gamma-probe assisted arthroscopic removal of osteoid osteoma in the hip joint.
Methods: Ten patients were diagnosed for osteoid osteoma of the hip; two in the femoral head, two in the acetabulum and six in the femoral neck. They all were treated by arthroscopic ablation of the nidus, assisted by endoscopic gamma probe. For this reason, a dose of 600 MBq Tc-99m was injected intravenously 16 to 20 hours prior the procedure. An endoscopic gamma probe was used to locate the nidus. Prompt and significant decrease of gamma irradiation was detected after complete removal of the nidus. Osteochondral defect located in the weight-bearing areas were subjected to microfracturing and osteochondroplasty was done in cases of concomitant CAM deformity. Patients were followed-up prospectively for a minimum of two years using Nonarthritic Hip Score (NAHS), Tegner activity score, quality of life questionnaire (EQ-5D). Post-operative MRIs were performed in patients with lesions in the weight-bearing areas and in case of any persistence of symptoms.
Results: The relative reduction of the gamma irradiation count immediately after ablation of the nidus was 44.9 % (33.3 % to 54.5 %). All patients experienced prompt pain relief after the procedure and a significant improvement according to all patient reported outcomes. Control MRIs revealed fibro-cartilaginous tissue repair of posto-ablation defects in the weight bearing areas; one patient showed signs of early osteoarthritis.
Conclusions: According to the results of this case series gamma-probe assisted arthroscopic removal of the osteoid osteoma from the hip joint is a safe and highly efficient. Gamma probe was found as a very useful device to locate the nidus exactly and to prevent incomplete or excessive removal of the bone.