Arthroscopic excision of osteoid osteoma of the elbow

Abstract

Osteoid osteomas (OOs) are benign tumors; intra-articular lesions are rare, and few localizations at the elbow are reported. We present 2 cases of OO in young patients; both described limited motion, and 1 patient reported pain. Diagnosis was suspected on the basis of computed tomography findings. Arthroscopic exploration of the joint was performed, bony biopsy was undertaken, and excision of the lesion was completed. In both cases, pathologic examination confirmed the diagnosis. The first patient had an excellent clinical result and returned to full activity in 2 weeks. The second patient underwent only partial excision of the lesion, probably because of the technical nature of the procedure (use of the shaver is not indicated in optimal treatment of OO). Arthroscopy is a useful and safe technique for OO excision when specific steps are followed: A shaver must be used only for exposition of big or deep lesions--not for treatment; in addition, bony biopsy must be performed, curettage must be completed with a curette, and a burr should be used at the end of the procedure to destroy hyperemic lesions. Elbow contracture does not have to be treated because it is directly related to the osteoma, and excision of the osteoma will restore full mobility.