Fischer Sebastian, Weber Sina, Gramlich Yves, Blank Marc, Buckup Johannes, Manegold Sebastian, Hoffmann Reinhard
Department of Foot and Ankle Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany.
Department for Trauma and Orthopaedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany.
Arthrosc Sports Med Rehabil. 2022 Jan 5;4(2):e575-e583. doi: 10.1016/j.asmr.2021.11.019. eCollection 2022 Apr.
The purpose of the study was to investigate the added value of electrothermal denervation (ETD) in arthroscopic debridement of anterior ankle impingement.
Between 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 ( = 29) with ETD of synovial and capsular tissue of the ankle and Group B ( = 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.
Twenty-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°; > .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.
The 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 I, prospective cohort study.
本研究旨在探讨电热去神经支配术（ETD）在前踝撞击症关节镜清理术中的附加价值。
在2019年5月至2020年12月期间，58例因胫距前关节撞击症接受关节镜下前路减压的患者被随机分为A组（n = 29），对踝关节滑膜和关节囊组织进行ETD，以及B组（n = 29），不进行ETD。患者包括37名男性和21名女性，平均年龄42岁。术前和术后使用视觉模拟量表足踝版（VAS FA）、足部功能指数（FFI）和美国矫形足踝协会评分（AOFAS）记录疼痛、活动范围（ROM）和功能。
术后24小时，使用VAS（满分10分）测量的静息疼痛水平平均为3.8分（A组：3.7分，B组：3.9分）。6周后，VAS FA平均为62.6分，ROM平均改善9.1°（A组：9.8°，B组：8.6°；P > 0.05），FFI平均为40.4分（A组：37.8分，B组：42.8分），AOFAS平均为73.1分（A组：71.3分，B组：75.1分）。所有术后评分与术前评分相比均有显著改善。两组之间未观察到显著差异。
使用ETD减轻疼痛的假设被推翻。在前踝撞击症关节镜清理术中增加ETD，在术后24小时和6周收集的评分（VAS - FA、FFI和AOFAS）方面未显示出任何显著优势，且住院时间和工作能力丧失情况相当。
I级，前瞻性队列研究。
