Abstract
PurposeThe purpose of the study was to investigate the added value of electrothermal denervation (ETD) in arthroscopic debridement of anterior ankle impingement.MethodsBetween May 2019 and December 2020, 58 patients who received arthroscopic anterior decompression for the impingement of the anterior tibiotalar joint were randomized to Group A (n = 29) with ETD of synovial and capsular tissue of the ankle and Group B (n = 29) without ETD. Patients included 37 men and 21 women, with a mean age of 42 years. The pain, range of motion (ROM), and function were recorded using the visual analog scale foot and ankle (VAS FA), the Foot Function Index (FFI), and the American Orthopaedic Foot and Ankle Society Score (AOFAS), both preoperatively and postoperatively.ResultsTwenty-four hours after surgery, the pain level at rest using the VAS (worst 10 points) was 3.8 points on average (Group A: 3.7, Group B: 3.9). After 6 weeks, the mean VAS FA was 62.6 points, and ROM improved by an average of 9.1° (Group A: 9.8°, Group B: 8.6°; P > .05), the mean FFI was 40.4 points (Group A: 37.8, Group B: 42.8), the mean AOFAS was 73.1 points (Group A: 71.3, Group B: 75.1). All postoperative scores improved significantly compared with preoperative scores. No significant differences were observed between groups.ConclusionsThe hypothesis of pain reduction with the use of ETD was refuted. The addition of ETD as part of the arthroscopic debridement of the anterior ankle impingement did not show any significant superiority in terms of the collected scores (VAS-FA, FFI, and AOFAS) at 24 hours and 6 weeks after the surgery and resulted in a comparable length of stay in the hospital and incapacity to work.Level of EvidenceLevel I, prospective cohort study.
Highlights
The genesis of anterior ankle impingement syndrome is typically traumatic, with the proliferation of bone and soft tissues, consisting of synovialFrom the Department of Foot and Ankle Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany (S.F., M.B., S.M.); Department for Trauma and Orthopaedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany (S.W., Y.G., R.H.); and Department of SporttraumatologyeKnee and Shoulder Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany (J.B.).Full ICMJE author disclosure forms are available for this article online, as supplementary material.Electrothermal denervation (ETD) describes the partial interruption of the sensitive nerve supply to the joint mucosa
All patients undergoing an arthroscopic debridement of the ankle joint were recruited during consultation at the study center
The diagnosis of anterior ankle impingement was made on the basis of a clinical examination and the results of radiographic and magnetic resonance (MR) tomographic imaging, depicted in Figs 2 and 3
Summary
The genesis of anterior ankle impingement syndrome is typically traumatic, with the proliferation of bone and soft tissues, consisting of synovial. Electrothermal denervation (ETD) describes the partial interruption of the sensitive nerve supply to the joint mucosa. A high-frequency current at the tip of the probe is guided by video-optical control to sclerotize the capsular and mucosal tissue along the front edge of the tibia and the neck of the talus. ETD of the synovium and the coagulation of small hemorrhages is an established procedure for the knee joint, especially peripatellar, the value of ETD at the anterior ankle has not yet been established.[11,12,13]. The purpose of the study was to investigate the added value of ETD in arthroscopic debridement of anterior
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