Computed tomography–guided radiofrequency ablation in the treatment of intra-articular proximal femoral osteoid osteoma

Objective: The present study aimed to evaluate the clinical success of computed tomography (CT)-guided radiofrequency ablation (RFA) in the treatment of proximal femoral located intra-articular osteoid osteoma (IAOO). Methods: This retrospective study included consecutive patients with clinical and CT imaging features suggestive of IAOO who were treated using a standardized CT-guided RFA technique between January 2020 and September 2024. The clinical, demographic, and radiological characteristics of the patients were documented. The e!cacy and results of the RFA treatment were evaluated. Results: Based on the inclusion criteria, 20 patients were included in the study. The mean follow-up period was 29.2 months (range: 6-48 months). The median procedure time was 43 minutes. No immediate or late major or minor complications were recorded. Technical success was achieved in 100% of the cases. In 3 of 20 patients, pain symptoms recurred within the first month, so RFA was performed again, and full clinical success was achieved. The preoperative mean Visual Analogue Scale (VAS) score was 7.4 (range: 5-10). The postoperative first month mean VAS score was 1.2 (range: 0-2). Conclusion: Computed tomography-guided RFA is a highly safe and e"ective technique that can be considered as the first choice for treating symptoms associated with proximal femoral IAOO. Performing all manipulations under CT guidance at all stages of the procedure, accessing the nidus through extra-articular normal bone, and centralizing the nidus with the RFA probe facilitates the safety of the technique and prevents damage to the articular cartilage. Ü Level of Evidence: Level IV, Therapeutic Study.