Subtalar arthroscopy is carried out as an outpatient procedure under general or spinal anaesthesia. The patient is placed in the supine position with the knee bended in an angle of approximately 45 degrees. The involved leg is marked with an arrow to avoid wrong side surgery. A tourniquet is inflated around the thigh for haemostasis.
For irrigation normal saline is used, however ringers solution is also possible. Gravity inflow is adequate for irrigation. When needed a pressure bag is inflated up to 100 mmHg.
A 2.7 mm arthroscope of 11 cm length with an inclination angle of 30 degrees in combination with a 3.8 or 4.6 mm high-volume sheath is routinely used, permitting excellent visualization within the sinus tarsi.
Anatomic landmarks for portal placement include the fibula tip and the sinus tarsi. The first portal is created 1 cm anterior to the tip of the fibula, directly over the sinus tarsi. The second portal is located 2,5-3 cm anterior to the first portal.