Clinical characteristics,surgical treatment,and prognosis of osteoid osteoma in middle-aged and elderly patients

YANG Yong-kun; ZHANG Qing; NIU Xiao-hui; LIU Wei-feng

doi:10.3969/j.issn.2095-252X.2025.11.004

Abstract：Objective Osteoid osteoma is more common in adolescents and very rare in middle-aged and elderly patients.The purpose of this study is to analyze the clinical manifestations,imaging characteristics,surgical methods,and prognostic features of elderly patients with osteoid osteoma.Methods A total of 10 middle-aged and elderly patients with osteoid osteoma who underwent surgical treatment in our hospital from 2015 to 2024 were enrolled,with an average age of 55.1 years(range:51-65 years),including 6 males and 4 females.All patients received surgical treatment assisted by computer intelligence,including 8 cases with computer navigation assistance and 2 cases with robot assistance.The surgical methods included 8 cases of open curettage of the lesion and 2 cases of minimally invasive radio-frequency ablation.Results The average duration of pain for patients before surgery was 36.6 months(range:8-132 months).The lesion site included 5 cases of femur,2 cases of radius,1 case of ulna,1 case of humerus,1 case of tibia and 1 case of fibula.There were 4 cases of tumor nests located at the metaphysis,5 cases at the diaphysis,and 1 case near the articular surface.The relative position relationship between tumor nests and cortical bone included 4 cases in the cortex,4 cases outside the cortex,and 2 cases in the medullary cavity.The average pain VAS scores of patients were 4.7(3-6)points preoperative and 0.2(0-1)points postoperative.The postoperative scores were significantly lower than preoperative scores(P<0.001).The average follow-up period postoperative was 56.2 months(range:12-111 months),and there was 1 case of recurrence postoperatively.The recurrence rates of the navigation group and the robot group were 12.5%(1/8)and 0%(0/2),respectively,with no significant difference(P=0.621).There were significant differences in postoperative recurrence rate between open surgery(0%)and percutaneous radio-frequency ablation surgery(50%)(P=0.026).One case had delayed wound healing postoperatively and no other complications were observed.Conclusions The clinical manifestations of middle-aged and elderly patients with osteoid osteoma are similar to those of adolescent patients,but the history of pain preoperative is relatively long.Precise surgery assisted by robots or computer navigation can effectively treat osteoid bone tumors and provide satisfactory pain relief with good safety.