Cryoablation versus Radiofrequency Ablation for the Treatment of Osteoid Osteoma.

PURPOSE: To explore the safety and efficacy of cryoablation versus radiofrequency ablation for the treatment of primary and recurrent osteoid osteomas and to explore predictors of success. MATERIALS AND METHODS: All thermal ablations of osteoid osteomas(OO) were retrospectively reviewed at a single institution, comprising 99 consecutive treatments (57 RFA and 42 cryoablation) in 93 patients (64 male, average age 17 years). Rates of technical success, clinical success, osteoid osteoma recurrence, and curative response were calculated and compared between groups. Predictors of outcomes were analyzed using binary logistic regression. RESULTS: Technical success was achieved in all but one patient. Of the 92 technically successful first-time ablations, clinical success was achieved in 87 patients (95%) in the overall cohort, 93% (51/55) who underwent RFA, and 97% (36/37) who underwent cryoablation (p=0.343). OO recurrence occurred in 6 out of 87 (7%) clinically successful ablations, with 10% (5/51) in the RFA group and 3% (1/36) in the cryoablation group (p=0.202). The curative response rate after one or two ablations without requiring surgery was 97% (88/92). Six patients underwent thermal ablation of a residual or recurrent OO, with 5 achieving a curative response (83%). No significant predictors of clinical success, OO recurrence, or curative response were identified. One major and one moderate adverse event were identified, both after cryoablation. CONCLUSIONS: Both cryoablation and RFA have a high curative response rate and excellent safety for the primary and secondary treatment of osteoid osteoma. No factors were identified to predict failed responses.

Duke Scholars

Author William Curtis Eward Orthopaedic Surgery

Author Charles Yoon Kim Radiology, Interventional Radiology