Osteoscopic versus open surgery for the treatment of enchondroma in the foot

Arch Orthop Trauma Surg. 2023 Aug;143(8):4899-4905. doi: 10.1007/s00402-023-04816-y. Epub 2023 Feb 23.

Abstract

Introduction: The conventional treatment of enchondromas is the open surgery with curettage of lesions. Osteoscopic surgery is a minimally invasive endoscopic approach for lesions inside bone. The aim of this study was to evaluate the feasibility of the osteoscopic surgery in comparison with the conventional open surgery for patients with foot enchondromas.

Materials and methods: A retrospective cohort study comparing patients with foot enchondromas treated with osteoscopic or open surgery from 2000 to 2019. Functional evaluations were based on both the AOFAS score and the Musculoskeletal Tumor Society (MSTS) functional rate. Complication and local recurrence were evaluated.

Results: Seventeen patients underwent endoscopic surgery, and eight patients underwent open surgery. The AOFAS score was higher in the osteoscopic group than the open group at 1 and 2 weeks after surgery (mean, 89.18 vs 67.25 [p = 0.001], 93.88 vs 79.38 [p = 0.004]). The MSTS functional rate was also higher in the osteoscopic group than the open group at 1 and 2 weeks after surgery (mean, 81.96 vs 59.58% [p = 0.00], 90.98 vs 75.00% [p = 0.02]). No statistical differences were found after 1-month of surgery. The osteoscopic group had lower complication rate than the open group (12 vs 50%; p = 0.04). No local recurrence was found in any groups.

Conclusion: The osteoscopic surgery is feasible to provide earlier functional recovery and fewer complications than the open surgery.

Keywords: Bone tumor; Enchondroma; Endoscopy; Foot; Osteoscopy; Toe.

MeSH terms

  • Bone Neoplasms* / pathology
  • Bone Neoplasms* / surgery
  • Chondroma* / pathology
  • Chondroma* / surgery
  • Curettage
  • Foot / surgery
  • Humans
  • Retrospective Studies
  • Treatment Outcome