Uploaded November 2025 | Updated September 2026, 1 week ago
Dr. John Kennedy demonstrates how the upgraded 2.0 system enhances diagnostic accuracy, improves patient comfort, and simplifies treatment of both anteromedial and anterolateral ankle impingement.
This video provides a detailed surgical walkthrough of NanoNeedle™ Ankle Arthroscopy, showcasing how the NanoNeedle™ Scope 2.0 transforms anterior ankle procedures through clearer visualization, safer portal creation, and seamless in‑office execution.
The procedure begins by identifying the superficial peroneal nerve, which is the structure most at risk during portal creation. Using the third‑ and fourth‑toe flexion sign, the nerve becomes more prominent, ensuring safe placement of the standard anterolateral and medial portals. After numbing the joint with a 1:1 mixture of Marcaine and lidocaine, the team allows the anesthesia to take effect while preparing the NanoNeedle™ 2.0 setup—an important step in what Dr. Kennedy stresses is a true team‑based procedure.
With the portals established, the NanoNeedle™ Scope 2.0 is inserted. The clarity provided by the new 720×720 sensor offers exceptional visualization of the tibia, talus, and the entire anterior joint line. This enhanced image quality allows precise assessment of soft‑tissue impingement, cartilage changes, and ligament hypertrophy. On the lateral side, transillumination reveals structures such as the AITFL/Bassett’s ligament, which is often scarred or hypertrophic following recurrent ankle sprains and can cause painful snapping and osteochondral wear.
Through the lateral working portal, Dr. Kennedy uses a 3.5 shaver, then optionally a burr, to resect hypertrophic soft tissue and remove bony spurs contributing to anterolateral impingement. With the patient awake, he explains each step, describing normal vibratory sensations from the shaver and reassuring them throughout. Proper stabilization of the NanoNeedle™ scope against the body minimizes hand tremor and enhances steady visualization within the joint.
After lateral resection, attention shifts to the medial gutter for anteromedial impingement. A new 2.0 biter with a graphite‑coated profile is introduced—emphasizing reduced glare and efficient cutting. The biter removes the fibrotic tissue, followed by shaver contouring to leave a clean, smooth articular border. Dr. Kennedy demonstrates how dorsiflexing the ankle reveals hidden anterior osteophytes that should not be overlooked. The combination of soft‑tissue resection, bony decompression, and portal switching highlights the versatility of NanoNeedle™ technology for full anterior ankle access.
Throughout the case, Dr. Kennedy emphasizes the critical role of an experienced nurse and rep, particularly in an awake arthroscopy environment—reinforcing that successful NanoNeedle™ Ankle Arthroscopy is a coordinated team effort. By the end of the procedure, both medial and lateral impingement sources are fully removed, restoring smooth talar gliding and preventing progression to osteochondral lesions.
👇 Helpful Arthrex Reference Links:
NanoNeedle™ Arthroscopy Solutions: arthrex.com/nanoscope
Learn more: arthrex.info/3M6unFz
👍 Like if you want more NanoNeedle™ technique breakdowns
💬 Comment with questions on anterior impingement or portal strategy
🔔 Subscribe for more minimally invasive ankle arthroscopy videos
Arthrex is a global leader in orthopedic surgical innovation, dedicated to advancing minimally invasive techniques and medical education. Our mission is to help surgeons treat their patients better by providing cutting-edge products, expert training, and comprehensive resources for orthopedic procedures, including sports medicine, joint preservation, and trauma care.
Stay Connected: 👍 Subscribe to our channel for the latest in orthopedic surgical techniques and product updates.
📱 Follow Arthrex on:
LinkedIn: / linkedin.com/company/arthrex
Facebook: / facebook.com/Arthrex
Instagram: / instagram.com/arthrexmeded
X: https://x.com/arthrex
Dr. John Kennedy demonstrates how the upgraded 2.0 system enhances diagnostic accuracy, improves patient comfort, and simplifies treatment of both anteromedial and anterolateral ankle impingement.
This video provides a detailed surgical walkthrough of NanoNeedle™ Ankle Arthroscopy, showcasing how the NanoNeedle™ Scope 2.0 transforms anterior ankle procedures through clearer visualization, safer portal creation, and seamless in‑office execution.
The procedure begins by identifying the superficial peroneal nerve, which is the structure most at risk during portal creation. Using the third‑ and fourth‑toe flexion sign, the nerve becomes more prominent, ensuring safe placement of the standard anterolateral and medial portals. After numbing the joint with a 1:1 mixture of Marcaine and lidocaine, the team allows the anesthesia to take effect while preparing the NanoNeedle™ 2.0 setup—an important step in what Dr. Kennedy stresses is a true team‑based procedure.
With the portals established, the NanoNeedle™ Scope 2.0 is inserted. The clarity provided by the new 720×720 sensor offers exceptional visualization of the tibia, talus, and the entire anterior joint line. This enhanced image quality allows precise assessment of soft‑tissue impingement, cartilage changes, and ligament hypertrophy. On the lateral side, transillumination reveals structures such as the AITFL/Bassett’s ligament, which is often scarred or hypertrophic following recurrent ankle sprains and can cause painful snapping and osteochondral wear.
Through the lateral working portal, Dr. Kennedy uses a 3.5 shaver, then optionally a burr, to resect hypertrophic soft tissue and remove bony spurs contributing to anterolateral impingement. With the patient awake, he explains each step, describing normal vibratory sensations from the shaver and reassuring them throughout. Proper stabilization of the NanoNeedle™ scope against the body minimizes hand tremor and enhances steady visualization within the joint.
After lateral resection, attention shifts to the medial gutter for anteromedial impingement. A new 2.0 biter with a graphite‑coated profile is introduced—emphasizing reduced glare and efficient cutting. The biter removes the fibrotic tissue, followed by shaver contouring to leave a clean, smooth articular border. Dr. Kennedy demonstrates how dorsiflexing the ankle reveals hidden anterior osteophytes that should not be overlooked. The combination of soft‑tissue resection, bony decompression, and portal switching highlights the versatility of NanoNeedle™ technology for full anterior ankle access.
Throughout the case, Dr. Kennedy emphasizes the critical role of an experienced nurse and rep, particularly in an awake arthroscopy environment—reinforcing that successful NanoNeedle™ Ankle Arthroscopy is a coordinated team effort. By the end of the procedure, both medial and lateral impingement sources are fully removed, restoring smooth talar gliding and preventing progression to osteochondral lesions.
👇 Helpful Arthrex Reference Links:
NanoNeedle™ Arthroscopy Solutions: arthrex.com/nanoscope
Learn more: arthrex.info/3M6unFz
👍 Like if you want more NanoNeedle™ technique breakdowns
💬 Comment with questions on anterior impingement or portal strategy
🔔 Subscribe for more minimally invasive ankle arthroscopy videos
Arthrex is a global leader in orthopedic surgical innovation, dedicated to advancing minimally invasive techniques and medical education. Our mission is to help surgeons treat their patients better by providing cutting-edge products, expert training, and comprehensive resources for orthopedic procedures, including sports medicine, joint preservation, and trauma care.
Stay Connected: 👍 Subscribe to our channel for the latest in orthopedic surgical techniques and product updates.
📱 Follow Arthrex on:
LinkedIn: / linkedin.com/company/arthrex
Facebook: / facebook.com/Arthrex
Instagram: / instagram.com/arthrexmeded
X: https://x.com/arthrex
