In the setting of a benign intra-osseous lesion infiltrating the growth plate, arthroscopic retrieval or excision under a computed tomography-based navigation system should be considered before proceeding with open surgery.Ī 16-year-old Japanese girl who was a high school student noticed left knee joint pain with joint motion and a decrease in weight-bearing ability, which started nine months before her initial presentation to our facility. Therefore, in an accessible location in the distal femur, endoscopic excision of chondroblastoma under navigation system guidance can be performed with minimal operative damage. Wide excision with total removal of the chondroblastoma in the distal femur often requires large exposure with associated drawbacks, where a wide excision near the growth plate can potentially lead to growth disturbance.
To prevent recurrence of chondroblastoma and growth disturbance, we used a computed tomography-based navigation system with registration technique involving skin marker fiduciaries and endoscopic curettage of the lesion. Computed tomography and magnetic resonance imaging studies of the left knee showed a radiolucent lesion with marginal sclerosis and lobular homogeneous hypo-intensity and hyper-intensity signals in the distal epiphysis of the left femoral epiphysis, carried through to the growth plate. Case presentationĪ 16-year-old Japanese girl presented to our facility with left knee joint pain, which started nine months before her initial examination. In our patient’s case, we used a computed tomography-based navigation system with registration technique involving skin marker fiduciaries and endoscopic curettage of the lesion. To prevent recurrence, complete curettage is important however, such an approach can be extremely difficult to perform precisely when the chondroblastoma arises deep in the epiphysis. It is generally regarded as a benign neoplasm, but sometimes it grows aggressively or recurs. Chondroblastoma is a benign bone tumor with a relatively high incidence in older children and adolescents during the period of active epiphyseal growth.
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