Postero-medial Approach Procedure in the Supine Position for One-step Anterior and Posterior Ankle Arthroscopy

Standard arthroscopy of the ankle does not allow to approach at the same time the anterior and posterior compartments. Keeping the patient supine and with the application of judicious traction, anterior ankle arthroscopy allows to examine the various intra-articular structures, but treat is limited only to anterior pathology. Also, it is not possible to explore posterior compartment and posterior hindfoot through an anterior approach. Normally, for those patients in whom both the anterior and posterior compartments were to be operated upon, surgery is stopped, and the patient has to be re-positioned. We describe a 2 postero-medial hindfoot portals procedure, which allows to reach both the posterior aspect of the ankle joint and the extra-articular compartment of the hindfoot keeping the patient supine throughout the procedure. After arthroscopy of the anterior compartment using standard anterior portals, 2 postero-medial endoscopic approaches make it possible to visualize and treat pathologies of the posterior ankle and of the hindfoot, without prolonging the operation through the need to reposition the patient in the prone position.