Electrothermal Denervation of Synovial and Capsular Tissue Does not Improve Postoperative Pain in Arthroscopic Debridement of Anterior Ankle Impingement—A Prospective Randomized Study

PURPOSE: The purpose of the study was to investigate the added value of electrothermal denervation (ETD) in arthroscopic debridement of anterior ankle impingement. METHODS: 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 (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. RESULTS: 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°; 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. CONCLUSIONS: 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 OF EVIDENCE: Level I, prospective cohort study.