Basics of Ankle Arthroscopy Part 2: Surface Anatomy, Portal Placement, and Diagnostic Evaluation for Anterior Ankle Arthroscopy

Abstract

Ankle arthroscopy is an important diagnostic and therapeutic tool in the treatment of pathologies of the ankle joint. In a series of 7 articles, the basics of ankle arthroscopy are reviewed. In this article (Part II), anterior ankle surface anatomy, portal placement, and diagnostic arthroscopy are reviewed. We also review benefits and drawbacks associated with a 1.9-mm 0° arthroscope in comparison to a standard 2.7-mm or 4.0-mm 30° arthroscope.

Fig 1

Arthroscopic approach to the left cadaveric ankle via the anterolateral and anteromedial portals. Visualized are the anteromedial portal, anterolateral portal, fibula, medial malleolus, talus, and anterior joint line. Figure used with permission from the senior author (J.G.K.), published by Colasanti et al.

Fig 2

Inversion and plantarflexion of the right ankle, demonstrating the superficial peroneal nerve (SPN). Visualized are the SPN, anteromedial portal, and anterolateral portal.

Fig 3

Arthroscopic view of the anterocentral aspect of the of the right ankle through the anteromedial portal. Visualized is the articulation between the tibial plafond and talus, with some surrounding scar tissue.

Fig 4

Arthroscopic view of the anteromedial aspect of the of the right ankle through the anterolateral portal. Visualized is a bony exostosis of the tibial plafond with adjacent fibrotic tissue and the articulating talar dome.

Fig 5

Arthroscopic view of the medial gutter of the right ankle through the anterolateral portal. Visualized is an exostosis of the talus and the shaver.

Fig 6

Arthroscopic view of the trifurcation of the right ankle through the anterolateral portal. Visualized is the lateral talar dome, fibula, distal lateral tibial plafond, and hypertrophic distal fascicle of the anterior tibio-fibular ligament (ATiFLdf).