Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2021; 12(7): 505-514
Published online Jul 18, 2021. doi: 10.5312/wjo.v12.i7.505
Arthroscopic removal as an effective treatment option for intra-articular osteoid osteoma of the knee
Mihovil Plečko, Alan Mahnik, Damjan Dimnjaković, Ivan Bojanić
Mihovil Plečko, Alan Mahnik, Damjan Dimnjaković, Ivan Bojanić, Department of Orthopedic Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Ivan Bojanić, Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Author contributions: Bojanić I designed the study; Plečko M and Mahnik A participated in the acquisition of data; Plečko M, Dimnjaković D and Bojanić I analyzed the data, and drafted the initial manuscript; Mahnik A revised the article critically for important intellectual content; Plečko M, Mahnik A, Dimnjaković D and Bojanić I approved the final version of the article to be submitted.
Institutional review board statement: The study was approved by the Institutional Ethics Committee (8.1-20/187-2 No. 02/21 AG).
Informed consent statement: All participants agreed to be enrolled in the study.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mihovil Plečko, MD, Doctor, Department of Orthopedic Surgery, University Hospital Centre Zagreb, Šalata 7, Zagreb 10000, Croatia. mplecko@kbc-zagreb.hr
Received: February 27, 2021
Peer-review started: February 27, 2021
First decision: March 31, 2021
Revised: April 7, 2021
Accepted: July 12, 2021
Article in press: July 12, 2021
Published online: July 18, 2021

Intra-articular osteoid osteoma (iaOO) can be found in 5.2% up to 10% of cases. They may cause non-specific symptoms, mimicking degenerative or traumatic pathologies. If iaOO is left untreated, it may lead to severe muscle atrophy, tenderness, swelling, and limited range of motion. Therefore, surgical treatment is recommended. The main goal of surgical treatment is complete removal or destruction of iaOO.


To evaluate the efficiency of arthroscopic removal of iaOO of the knee in our cases and cases available in the literature.


Analysis of available hospital records of four patients with iaOO of the knee treated by arthroscopic removal from August 2005 to December 2015 at our Department was performed. All patients had a diagnosis of iaOO confirmed by histopathologic analysis. Additional literature review of cases of iaOO of the knee available on PubMed and Google Scholar was made. All cases of iaOO of the knee treated by arthroscopic or arthroscopically assisted removal were reviewed in order to further evaluate the efficiency of the method.


The average age of patients included in our study was 23.2 (range 16-37) years. The average duration of the symptoms prior to surgery was 14.2 (range 6-24) months. All of the patients had persistent knee pain. Three patients reported worsening of pain during the night, while two reported worsening of pain during activity. Three patients reported alleviation of pain on non-steroidal anti-inflammatory drugs (NSAIDs), while one patient reported partial alleviation of pain on NSAIDs. No intraoperative complications were noted, and the postoperative period was uneventful in all patients. The patients reported immediate pain relief in the postoperative period. No recurrence of the disease was noted in any of the patients during the follow-up period of at least 24 mo. The literature review revealed 14 cases with an average age of 27.6 (range 16-48) years and onset of symptoms 27.7 (range 6-108) months prior to surgery, with recurrence of the disease noted in a single case.


Arthroscopic removal is an efficient treatment method that allows excision of iaOO that is neither insufficient nor excessive, thus avoiding disease recurrence while obtaining adequate material for histopathologic analysis.

Keywords: Osteoid osteoma, Knee, Arthroscopy, Bone diseases, Surgical procedures, Operative, Pathology, Surgical

Core Tip: Advantages of the arthroscopic or arthroscopic assisted removal of the intra-articular osteoid osteoma of the knee are the ability to obtain adequate material for histopathologic analysis and to perform neither excessive nor insufficient excision, thus avoiding disease recurrence, as well as chondral lesions and bone necrosis.