Ankle Arthroscopy

Anterior ankle impingement occurs when bone spurs (osteophytes) form on the front of the tibia and/or the talus and physically block the ankle from bending upward (dorsiflexion) fully. Athletes feel this as a deep ache or sharp pain at the front of the ankle when squatting, climbing, or pushing off a surface. Dancers describe it as a loss of plié depth. The spurs develop over years from repetitive forced plantarflexion — the same motion that jams the ankle bones together. Arthroscopic debridement removes the spurs and restores motion. Recovery is relatively fast (6-8 weeks to sport) and results are generally excellent.

Osteochondral lesions of the talus (OLTs) are areas where cartilage and underlying bone have been damaged, usually from a previous ankle sprain or chronic instability. Small lesions under 1.5 cm are typically treated with microfracture: tiny holes are drilled into the exposed bone to stimulate a blood clot that produces fibrocartilage. Larger lesions may require cartilage grafting — either autograft from another part of the body or allograft from a donor. Newer techniques include OATS (osteochondral autograft transfer) and matrix-assisted cartilage implantation. The technique chosen depends on lesion size, depth, and whether bone has also been lost.

Yes — and it often should be. Osteochondral lesions are found in 40-65% of ankles with chronic instability when examined arthroscopically. Combining arthroscopy with a Broström ligament repair in the same session addresses both problems without requiring a second surgery. The arthroscopic portion adds 20-30 minutes and the recovery is largely similar. If you are planning a Broström procedure and have not had an MRI or CT of the cartilage surfaces, it is worth asking your surgeon whether combined arthroscopy should be part of the plan.