Andrea Angelini1, Andrès Felipe Varela-Osorio2, Giulia Trovarelli1, Antonio Berizzi1, Gabriele Zanotti3, Pietro Ruggieri4. 1. Department of Orthopedics and Orthopedic Oncology, University of Padova, Via Giustiniani 3, 35128, Padua, Italy. 2. Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy. 3. Department of Orthopedics, Civilian Hospital of Lugo, Lugo, Ravenna, Italy. 4. Department of Orthopedics and Orthopedic Oncology, University of Padova, Via Giustiniani 3, 35128, Padua, Italy. pietro.ruggieri@unipd.it.
Abstract
PURPOSE: To analyze the clinical and radiographic characteristics, treatment, and outcome of patients with elbow osteoblastoma. PATIENTS AND METHODS: We present 13 patients (7 males and 6 females; mean age, 28 years) diagnosed and treated for an elbow osteoblastoma from 1975 to 2012. Mean follow-up was 29 months (range 12-60 months). Clinical presentation, imaging, surgical treatment, complications, range of elbow motion, and functional outcome were evaluated. The MSTS, DASH, and OXFORD scores were used. RESULTS: Main symptom was pain (all patients) accompanied by stiffness (8 patients) and swelling or tumefaction (7 patients), with a median duration of symptoms of 32 months (range 6-96 months). Distal humerus was affected in 10 patients, proximal ulna in 2 patients, and proximal radius in one patient. All patients underwent surgical therapy that consisted of curettage of the lesion (7 patients), curettage and bone allografting (3 patients), wide resection (2 patients; total distal humerus and resection of the radial head), and radiofrequency thermal ablation (1 patient). One patient experienced a recurrence after surgical treatment. The mean MSTS score after treatment was 87% (range 50-100%), which corresponds to excellent results. CONCLUSIONS: Intralesional surgery is successful in tumor control in most patients with osteoblastoma of the elbow. Thermal ablation may be successful for smaller lesions. Most of the patients had a good-to-excellent functional outcome even if they had tumor-related elbow stiffness at diagnosis. LEVEL OF EVIDENCE: Therapeutic study, Level IV-1.
PURPOSE: To analyze the clinical and radiographic characteristics, treatment, and outcome of patients with elbow osteoblastoma. PATIENTS AND METHODS: We present 13 patients (7 males and 6 females; mean age, 28 years) diagnosed and treated for an elbow osteoblastoma from 1975 to 2012. Mean follow-up was 29 months (range 12-60 months). Clinical presentation, imaging, surgical treatment, complications, range of elbow motion, and functional outcome were evaluated. The MSTS, DASH, and OXFORD scores were used. RESULTS: Main symptom was pain (all patients) accompanied by stiffness (8 patients) and swelling or tumefaction (7 patients), with a median duration of symptoms of 32 months (range 6-96 months). Distal humerus was affected in 10 patients, proximal ulna in 2 patients, and proximal radius in one patient. All patients underwent surgical therapy that consisted of curettage of the lesion (7 patients), curettage and bone allografting (3 patients), wide resection (2 patients; total distal humerus and resection of the radial head), and radiofrequency thermal ablation (1 patient). One patient experienced a recurrence after surgical treatment. The mean MSTS score after treatment was 87% (range 50-100%), which corresponds to excellent results. CONCLUSIONS: Intralesional surgery is successful in tumor control in most patients with osteoblastoma of the elbow. Thermal ablation may be successful for smaller lesions. Most of the patients had a good-to-excellent functional outcome even if they had tumor-related elbow stiffness at diagnosis. LEVEL OF EVIDENCE: Therapeutic study, Level IV-1.
Entities:
Keywords:
Curettage; Elbow; Elbow joint stiffness; Local recurrence; Osteoblastoma
Authors: Cláudia Regina Gomes Cardim Mendes de Oliveira; Berenice Bilharino Mendonça; Olavo Pires de Camargo; Emilia Modolo Pinto; Sérgio Antonio Barbosa Nascimento; Maria do Rosario D O Latorre; Maria Claúdia Nogueira Zerbini Journal: Clinics (Sao Paulo) Date: 2007-04 Impact factor: 2.365