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The authors report the case of an osteoid osteoma of the acetabular roof in a 17-year-old sportsgirl successfully treated by radiofrequency ablation, with a mid-term evidence of cartilage loss. Extra-articular access and exact positioning of the needle electrode exclude direct operative chondral damage. Intense physical activity could be an aggravating factor for the chondropathy. It is difficult to determine whether the acetabular cartilage joint was damaged only by thermo-ablation or if it had also been weakened before by the O.O. The authors caution practitioners from using this technique for para-articular lesions, especially near weight-bearing joints.