Ankle arthroscopy is an effective procedure for the evaluation and management of osteochondritis dissecans of the talus. For active individuals with detached lesions, excision, curettage, and drilling are an effective treatment. The ability to drill arthroscopically significantly reduces the morbidity associated with open procedures. The use of an anterior cruciate ligament guide and the transmalleolar approach are techniques that have been advocated for the drilling of defects on the posteromedial aspect of the talar dome. However, we describe a new technique using the meniscal repair instrumentation that permits accurate arthroscopic localization and drilling of osteochondral lesions; no transmalleolar portal is required.
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