The medial gutter of the ankle is the synovial recess between the medial talar dome and the medial malleolus, accessible via the anteromedial ankle arthroscopy portal. It is the site of medial ankle impingement, osteochondral lesions of the medial talar dome, and post-traumatic medial gutter synovitis.
The medial ankle gutter is assessed arthroscopically via the anteromedial portal, positioned medial to the anterior tibial tendon at the joint line. Medial gutter impingement produces anteromedial ankle pain with dorsiflexion, often from deltoid ligament scarring or anteromedial talar osteophytes. Osteochondral lesions of the medial talar dome typically occur in the posteromedial aspect and require posterior or anteromedial portal access.
Synovial and soft tissue impingement in the medial ankle gutter producing anteromedial ankle pain with dorsiflexion, often from post-sprain fibrosis, treated by arthroscopic medial gutter debridement.
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