Minimally Invasive Excision of Subchondral Osteoid Osteoma Using O-Arm Navigation and Arthroscopic Visualization

Osteoid osteoma is the third most common benign bone tumor, composed of osteoid and woven bone that rarely exceeds 1.5 cm in dimension. The typical presentation is intense pain that mostly worsens at night and is relieved with non-steroidal anti-inflammatory drugs. X-ray is the initial imaging modality; however, CT scan is the modality of choice as it can identify almost all cases of osteoid osteoma. Our case demonstrates that the integration of O-arm navigation with arthroscopic visualization offers a novel and effective approach for managing subchondral osteoid osteomas. Although traditional surgical excision and CT-guided radiofrequency ablation have shown long-term high success rates, they are associated with more morbidity and cosmetically undesirable scarring. Our technique combines the benefits of both approaches while minimizing their respective limitations. This dual-modality approach proved particularly valuable in our young, active patient, where preservation of joint integrity and rapid return to function were paramount. The successful outcome suggests that this technique may represent a significant advancement in the surgical management of subchondral osteoid osteomas.