Arthroscopic treatment of sports-related anterior osteophytes in the ankle

Osteophytes on the anterior aspect of the tibia and anterior talus are common in athletes such as dancers, runners, and high jumpers who impact with quick and forceful dorsiflexion to this area. This pathology is often confirmed easily on lateral x-ray films. Excision, debridement, and/or abrasion arthroplasty can be performed arthroscopically to remove osteophytic bone. The joint space is easily approached and managed using small joint or even regular-sized arthroscopic instruments. Care is taken to reshape the anterior tibia and/or talus to its original contour, thus avoiding impingement of the joint space and scuffing of adjacent articular cartilage. Proper abrasion depths and punch lesions may be needed to expose bleeding capillary bone. This allows a regeneration of a fibrocartilage covering that not only decreases pain but also permits a return to functional and athletic activities. Postoperative treatment, including physical therapy, is described. Three case studies are presented that adequately demonstrate this problem, along with the corrective measures taken. Each case concludes with a brief summary of follow-up.