The Utilization of Osteoarticular Transfer System in the Treatment of Distal Femur Osteoid Osteoma: A Case Report

Introduction: Tumor excision of the subchondral bone of the distal femur epiphysis is technically challenging particularly in skeletally immature patients due to the open physis above and articular surface below. Preservation of the physis, maintenance of structural support to, and integrity of, the cartilage, and conservation of joint kinematics must all be considered and are often threatened by current percutaneous or open surgical treatment options. Materials and Methods: We present a case of a 16-year-old male athlete with a distal femur epiphyseal bone lesion. He underwent transarticular en bloc excision and autograft reconstruction using osteoarticular transfer system (OATS) technique. Results: Final pathology revealed complete excision of an osteoid osteoma. The patient had regained full strength and range of motion at 3 months postoperatively, and at 22 months postoperatively was free of disease and back to full level of athletic participation. Conclusions: This article describes a technique for excision of subchondral epiphyseal bone lesions in the distal femur in skeletally immature patients which mitigates the risk of complications associated with physeal injury, incomplete tumor resection, and iatrogenic injury to the overlying cartilage.