The use of the arthroscope as an adjunct in the resection of a chondroblastoma of the femoral head

doi:10.1016/0749-8063(95)90097-7

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Volume 11, Issue 1, February 1995, Pages 106-111

https://doi.org/10.1016/0749-8063(95)90097-7 Get rights and content

Abstract

We present a case of the use of an arthroscope as an adjunt in the resection of a tumor (chondroblastoma) of the femoral head. Use of the endoscope in this case allowed preservation of the femoral head and neck. Although the arthroscope has been used intraarticularly for the resection of tumors, to our knowledge it has not been used endosteally.

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Cited by (29)

Arthroscopic Management of Juxta-articular Proximal Humeral Chondroblastoma: The Bazooka Technique
2023, Arthroscopy Techniques
Chondroblastoma is a rare benign cartilaginous lesion located mostly in the epiphyses of the long bones. The most common locations are the proximal tibia or femur, distal femur, and proximal humerus. Open curettage and bone grafting constitute the mainstay treatment for this condition. Few reports have documented the use of arthroscopy in tumor surgery owing to the problem of inadequate removal and the difficulty of bone graft delivery to the tumor cavity. The bazooka technique should solve these 2 main problems. In this article, arthroscopic curettage and grafting are described for the treatment of juxta-articular proximal humeral chondroblastoma to lessen postoperative pain and thus enable early mobilization and a quicker rehabilitation in skeletally immature patients.
Arthroscopic management of Juxta-articular chondroblastoma with bone substitutes – A case report
2022, Journal of Clinical Orthopaedics and Trauma
Citation Excerpt :
Sporadic reports on arthroscopic treatment of chondroblastoma have been published as early as 1992 when Cohen et al. first reported excision of a proximal tibial chondroblastoma.2 Arthroscopy in treating chondroblastoma can be intra-articular or endosteal as suggested subsequently by Thompson et al.3 Though Bal et al. claimed arthroscopy to be an attractive option in accessible lesions, they acknowledged that the risk of intra-articular tumour dissemination and poor quality of biopsy specimen as drawbacks of this technique.4 While Shimizu et al. opined that arthroscopy should be avoided in chondroblastoma requiring aggressive curettage and claimed bone grafting was not possible arthroscopically,5 Khapchik et al. claimed that use of arthroscopy-assisted techniques for excision of benign bone tumours are potentially less painful, provide better cosmetic results and allow for early mobilization and better functional results.6
Chondroblastoma, a rare benign bone tumour arising from the epiphysis, accounts for approximately 1% of all primary bone tumours and is known to be locally aggressive with potential for metastases and local recurrence. Open surgical curettage is associated with high risk of recurrence and potential for damage to the physis resulting in growth disturbances. We report a 14-year-old girl with chondroblastoma involving the distal femoral epiphysis in whom an arthroscopic approach was employed for thorough curettage of the lesion under direct vision followed by cavity management using bone graft substitute. At seven years follow-up she is asymptomatic, has normal knee function and her radiographs have shown good osteointegration of the synthetic graft with no evidence of recurrence. By combining the principles of intra-articular and endosteal arthroscopy in select patients, both tumour excision and cavity management can be done arthroscopically.
Endoscopic Surgery for Symptomatic Unicameral Bone Cyst ofthe Proximal Femur
2013, Arthroscopy Techniques
Citation Excerpt :
For the proximal femur, only 2 cases have been reported in which endoscopic curettage was applied for benign bone lesions.8,9 Thompson and Woodward8 used an arthroscope as an adjunct in the resection of a chondroblastoma of the femoral head and reported the usefulness of the device, which resulted in minimal capsulotomy and osteotomy and no need to dislocate the hip joint. Similarly, Stricker9 performed endoscopic excision of a femoral head chondroblastoma and mentioned the effectiveness of the procedure with complete curettage possible through good visualization.
Recently, surgical treatment of a symptomatic unicameral cyst of the proximal femur has been achieved with less invasive procedures than traditional open curettage with an autologous bone graft. In this article we introduce endoscopic surgery for a symptomatic unicameral cyst of the proximal femur. The presented technique, which includes minimally invasive endoscopic curettage of the cyst and injection of a bone substitute, not only minimizes muscle damage around the femur but also enables sufficient curettage of the fibrous membrane in the cyst wall and the bony septum through direct detailed visualization by an endoscope. Furthermore, sufficient initial strength after curettage can be obtained by injecting calcium phosphate cement as a bone substitute.
Hip Arthroscopy: An Emerging Gold Standard
2006, Arthroscopy - Journal of Arthroscopic and Related Surgery
Arthroscopically assisted excision of osteoid osteoma involving the hip
2001, Arthroscopy
Citation Excerpt :
Increasing experience is being accumulated with percutaneous radiofrequency thermal coagulation, especially for lesions in difficult locations.15-19 Prior reports have described arthroscopically assisted excision of chondroblastoma involving the femoral head58 and knee,59 as well as osteoid osteoma of the proximal tibia20 and talus.21,22 We report for the first time the use of hip arthroscopy to treat intra-articular lesions involving the femoral neck and acetabulum.
Two cases of arthroscopically assisted excision of osteoid osteoma involving the femoral neck and acetabulum are presented. This technique allows for percutaneous excision of this benign bone lesion in those rare circumstances when it occurs in an intra-articular location. The approach enables direct visualization of the tumor as well as histologic confirmation. There was minimal morbidity, excellent relief of symptoms, and rapid functional restoration.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 1 (January), 2001: pp 56–61
Surgery of benign bone lesions in H2 region of femoral neck in children
2023, Chinese Journal of Pediatric Surgery

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Case reportThe use of the arthroscope as an adjunct in the resection of a chondroblastoma of the femoral head

Abstract

Arthroscopy

Benign chondroblastoma of bone

Bone sarcoma

Neoplastic diseases

Epiphyseal chondromatous giant cell tumors of the upper end of the humerus

Surg Gynecol Obstet

Chondroblastoma (Codman's tumour) of the thoracic spine

J Bone Joint Surg Am

Chondromyxoid fibroma of bone, with emphasis on its morphological relationship to benign chondroblastoma

Cancer

Chondroblastoma in the metaphysis of the femoral neck

J Bone Joint Surg Am

Benign chondroblastoma of bone

Br J Surg

Chondroblastoma of bone

Bone tumors

Benign chondroblastoma of bone

Benign chondroblastoma in the finger

J Bone Joint Surg Am

Benign chondroblastoma (Codman's tumor)

Benign chondroblastoma of bone

Benign chondroblastoma of bone

Benign chondroblastoma with recurrent soft-tissue and intra-articular lesions

Case report
The use of the arthroscope as an adjunct in the resection of a chondroblastoma of the femoral head