The efficacy and safety of microwave ablation in managing osteoid osteoma: a systematic review

Introduction: Microwave ablation (MWA) utilizes electromagnetic methods to destroy tumors, employing devices operating at 900 MHz or above frequencies. MWA has emerged as a recent alternative for treating osteoid osteoma (OO), providing similar accessibility, safety, and technical effectiveness as radiofrequency ablation. This systematic review aims to evaluate the safety and efficacy of MWA in treating OO. Methods: A systematic review of published studies on the use of MWA in managing OO was conducted. Studies were excluded if they were 1) not written in English, 2) case reports, 3) lacked adequate peer review, or 4) consisted solely of abstracts. Before full-text assessment, titles, and abstracts were screened. Extracted data included author, year, study design, patient count, age, gender, OO site, ablation power (watts), duration, complications, outcome, and recurrence. The data were analyzed and presented as means, frequencies, and percentages. Results: Eight studies, including 143 cases, met the inclusion criteria; among these cases, 59.44% were male, and the mean age was 19.03 ± 7.09. Most of the OOs were in the femur, 54.54%. MWA at 60 W was the prevailing power setting, utilized in 37 cases (25.87%), with an ablation time of 90 s for 95 cases (66.43%). Clinical success was achieved in 137 (95.80%) cases, with recurrence observed in 4 cases (2.80%). However, 16 minor and major complications were observed despite the overall success. Conclusion: Percutaneous MWA may represent an efficient choice for the minimally invasive management of OO, demonstrating a minimal risk of complications and recurrence.