Ankle arthroscopy is generally performed through anterior portals and provides good access to the anterior aspect of the ankle joint. However, the structure of the talus and the anatomical confines of the ankle joint limit access to posterior structures via this approach. Developments in the technique of posterior ankle arthroscopy have determined the appropriate site for portals with minimal risk of iatrogenic neurovascular injury. This facilitates treatment of conditions such as flexor hallucis longus (FHL) release, excision of os trigonum for posterior impingement, treatment of retro-calcaneal bursitis and treatment of ankle and subtalar joint pathology.

Posterior ankle arthroscopy is a relatively new technique and has recently been adopted by the senior author. This study was performed to explore the benefits and limitations of this procedure and to identify early post operative results.