One of the most exciting possibilities for MIS surgery is to combine ankle arthroscopy with ligament repair and reconstruction. Ankle sprains are common and generally resolve in 1-2 months. Unfortunately, some patients experience long term difficulties due to injuries to the ankle cartilage or ligaments which do not heal on their own. When physical therapy and bracing are not enough, your surgeon may recommend a procedure to evaluate and treat the damaged cartilage and repair the ligaments on the lateral ankle. This has traditionally been performed as a combined arthroscopic and open procedure. The joint is evaluated with small key hole incisions and a thin camera with special instruments to remove scar tissue and treat the cartilage. The older surgery involves a 3-4 inch incisions on the lateral ankle and repairing the ligaments back in place. With a MIS approach, the entire ligament repair can not be safely and effectively performed with an all arthroscopic technique utilizing an accessory portals 5mm in length to tie down the ligaments as opposed to a 3-4 inch scar, the incision is barely noticeable as shown in the pictures below. The red arrow indicates the accessory portal. The dark blue line on the left shows a typical incision for an open procedure extending from the posterior fibula towards the lateral foot.