Osteoblastoma of the elbow: analysis of 13 patients and literature review

Eur J Orthop Surg Traumatol. 2017 Aug;27(6):787-795. doi: 10.1007/s00590-017-1997-6. Epub 2017 Jun 20.

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.

Keywords: Curettage; Elbow; Elbow joint stiffness; Local recurrence; Osteoblastoma.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / physiopathology
  • Bone Neoplasms / surgery*
  • Child
  • Elbow
  • Elbow Joint / physiopathology
  • Elbow Joint / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Humerus
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Musculoskeletal Pain / etiology
  • Neoplasm Recurrence, Local / surgery*
  • Osteoblastoma / diagnostic imaging
  • Osteoblastoma / physiopathology
  • Osteoblastoma / surgery*
  • Radius
  • Range of Motion, Articular
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ulna
  • Young Adult