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Treatment options for degenerative joint disease of the ankle and subtalar joints are limited. When conservative management fails, the only effective procedure is arthrodesis. With the advent of the small arthroscope and the development of better instrumentation and distraction techniques, small joint arthroscopy has gained popularity as an important diagnostic and therapeutic tool in the treatment of ankle and subtalar disorders. Although the benefits of arthroscopic ankle arthrodesis are well established, and arthroscopic subtalar arthrodesis has been described recently, the role of arthroscopic debridement for degenerative joint disease of the ankle and subtalar joints remains controversial. Traditionally, operative arthroscopy for ankle arthritis has not met with great success; however, recent studies have shown that it can provide an interim alternative to arthrodesis in early arthritis with preserved range of motion. Lesions associated with arthritis, such as impinging osteophytes and loose bodies, can be treated effectively with arthroscopy.