Ankle arthroscopy What conditions can be treated with ankle arthroscopy? Unstable ankle - An ankle may be unstable because it is restraining tissues (bone, tendon) or more commonly the ligaments have been injured and are no longer competent or in the normal position. This is known as mechanical instability and though ankle arthroscopy will not by itself treat this condition, there are often associated problems within the ankle joint which will require an arthroscopy as well as addressing the underlying mechanical problem.
An ankle may also be subjectively unstable. This is when the normal restraints (bone, tendons and ligament) are working fine, but the ankle nevertheless feels unstable. This is usually due to a painful area within the joint such as synovitis injury, a plica, arthrofibrosis or a chondral or osteochondral injury. All of these conditions can be treated arthroscopically.
 Anterior ankle synovitis before and after removal with an arthroscopic shaver
Ankle pain following a fracture or sprain - ChondralFlap (1.1MB) Download movie (1.1MB)
Following an ankle fracture which has healed, there are a number of causes for ongoing pain. If the joint surface has been disrupted and either portions of the joint have been lost or it has not been possible to restore the joint back to its normal dimensions then arthritis may ensue with the symptoms that brings.
Occasionally, the metalwork used to fix an ankle fracture can become prominent or seem to be tender superficially and this would also produce pain. Very rarely, a condition known as a regional pain syndrome may occur, which will produce ongoing pain following ankle fracture.
Generally, any residual symptoms after an ankle fracture stand a chance of improving for twelve to eighteen months following the injury, depending on the underlying diagnosis. If symptoms persist and the preceding conditions have been excluded then there may be problems within the joint itself which are leading to ongoing symptoms. Common findings are either chondral or osteochondral injury, synovitic lesions, loose bodies or post-traumatic plica.
An osteochondral injury of the talar dome Footballers Ankle
This is a condition which is most often present in those who have engaged in kicking sports for a number of years. Footballers ankle manifests itself with pain at the front part of the ankle joint which remains well localised, often to the outer part of the ankle. It is present during activities which bring the foot closer towards the shin bone also known as the tibia. It is due to spurs of bone on one or other side of the ankle. As these approach each other ie when the foot moves upwards, they trap soft tissue within the ankle joint between them and produce localised pain. A spur of bone at the front of the ankle is also a common finding in ankle arthritis. In ankle arthritis the joint surfaces are not normal. Usually in a footballers ankle the joint surfaces are normal.  An otherwise normal ankle joint with an anterior tibial spur,also known as a Footballers Ankle
Ankle osteoarthritis
Debridement or fusion are the two arthroscopic options. See ankle Osteoarthritis for discussion and images.
Loose bodies - Loosebody (1.7MB) Download movie (1.6MB)
Pieces of bone and/or cartilage which may cause symptoms of instability or pain from the joint. Diseases of the synnovium (chondromatosis, early rheumatoid) 
Synnovial chondromatosis(1)
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