Long-term efficacy of percutaneous drill-biopsy under computed tomography guidance of osteoid osteomas of the hip and femur. A review of seven cases

En bine surgical excision of osteoid osteomas of the hip and femur is diffi cult because of problems with tumor boundary identification and the need to use internal fixation or bone grafting. We report our experience with seve n cases treated by percutaneous drill-biopsy under computed tomography guid ance. Patients. Six adults and one child with a mean age of 22 years treate d since 1995. All seven patients reported insomnia due to pain during a mea n of 10 months, improved by aspirin or other nonsteroidal antiinflammatory agents. The tumor was seen on plain radiographs in four cases and on comput ed tomography scans in all seven cases. Magnetic resonance imaging was diag nostic in only two cases. The tumor was in the femoral neck in four patient s, in the acetabulum in one, in the proximal femur in one, and at the dista l diaphyseal-metaphyseal junction of the femur in one. Method. A trephine w as used to remove the tumor under computed tomography guidance during a sho rt general anesthesia. Results. No serious complications were recorded. Ful l weight bearing was allowed starting at the forty-lighth hour in six of th e seven patients. immediate pain relief and a full recovery were obtained i n every case. Results were excellent in four patients and goad in three aft er a follow-up of 14 to 44 months. Conclusion. Percutaneous drill-biopsy of osteoid osteomas is a valuable alternative to conventional surgery in pati ents with tumors at sites that are difficult to access. The technique allow s early weight bearing and ensures a full recovery. (C) 2000 Editions scien tifiques et medicales Elsevier SAS.