Orthopedic Surgery

Feb. 25, 2026

Mayo Clinic not only offers open ankle surgery but also ankle arthroscopy, a minimally invasive procedure that has borrowed therapeutic concepts from research in other joints, especially research conducted within the medical center's own walls.

The evolution of ankle arthroscopy

Arthroscopy has a long and global history, with early development rooted in Japan. The technique initially gained traction in larger joints such as the knee and shoulder before being adapted for the foot and ankle. Historically, its role was primarily diagnostic. While it is still an important diagnostic tool, Kyle R. Duchman, M.D. — a sports medicine specialist and orthopedic surgeon at Mayo Clinic's campus in Rochester, Minnesota — notes that its use has expanded primarily due to increasing therapeutic indications.

Advances in optics, camera resolution and miniaturized instrumentation have transformed ankle arthroscopy into a versatile therapeutic platform. Surgeons can now address cartilage pathology, soft tissue impingement and syndesmotic injuries with precision. For example, with a high ankle injury, arthroscopy allows the surgeon to confirm the diagnosis and then treat the ankle immediately afterward, Dr. Duchman notes.

Diagnoses and procedures uniquely suited to arthroscopy

While many ankle conditions can be identified through physical exam and imaging, certain pathologies are best confirmed arthroscopically. Subtle chondric lesions, occult impingement and intra-articular debris, often associated with common issues such as ankle instability, require direct visualization for accurate assessment.

Some interventions are performed almost exclusively arthroscopically. Bone spurs contributing to anterior or posterior impingement, for instance, are optimally addressed through minimally invasive portals. Dr. Duchman emphasizes the technique's precision and efficiency in these scenarios.

Advantages over open surgery

For appropriately selected patients, arthroscopy offers meaningful advantages over open approaches. Smaller incisions reduce soft tissue morbidity, postoperative pain and wound complications. Earlier mobilization is another key benefit, often translating into faster functional recovery and improved patient satisfaction.

When arthroscopy is — and is not — the right choice

Despite its versatility, arthroscopy is not universally superior.

"There are situations where arthroscopy is 100% the right choice, and when used with good clinical understanding, it can be very impactful for patients," Dr. Duchman says.

Conversely, certain deformities, advanced arthritis or extra-articular pathology may require open or combined approaches. Appropriate patient selection remains central to achieving optimal outcomes.

Eligibility considerations

Two common indications stand out for use of ankle arthroscopy:

• Prior ligamentous injury. These situations require intra-articular assessment or treatment most accessible through arthroscopic visualization.
• Ankle impingement. Whether soft tissue or osseous, causing pain and motion restriction, this type of injury is particularly relevant for athletes such as gymnasts or dancers who rely on end-range mobility.

Why refer to Mayo Clinic?

Mayo Clinic offers numerous advantages for patients requiring ankle arthroscopy, particularly those with complex or refractory pathology. The institution has deep experience in cartilage repair and translational innovation.

Mayo Clinic's extensive history in cartilage restoration across multiple joints serves to inform its foot and ankle practice. Technologies developed for the knee and other joints — including investigational innovations from the RECLAIM project led by Daniel B. F. Saris, M.D., Ph.D. — have applications that may guide cartilage treatment in the ankle in the future. Dr. Duchman notes that he and foot and ankle specialist colleagues have learned a substantial amount about getting to cartilage in tight spaces and about cartilage restoration from research done on other joints at Mayo Clinic and the regular exposure to innovation in joint repair.

Mayo Clinic also offers patients the advantage of its multidisciplinary practice, meaning an ankle specialist can call in a specialist in another joint for consultation or refer patients internally for other related or unrelated conditions.

For more information

Refer a patient to Mayo Clinic.