The patient, a 52-year-old male. He was admitted to the hospital mainly because of right ankle soreness and discomfort for 3 years. Physical examination: limited dorsiflexion of the right ankle. Diagnosis: ankle impingement and osteochondral injury. Preoperative lateral X-ray showed anterior ankle impingement Preoperative orthopantomolecular X-ray showed cartilage injury of the medial talus shoulder Preoperative MRI Intraoperative microscopic synovial congestion and hyperplasia, planer cleanup Arthroscopic cartilage debridement, spatula chondroplasty Anterior tibial hyperplasia impinging on cartilage, forming cartilage injury Arthroscopic cartilage debridement, spatula chondroplasty, microfracture. Intraoperative photograph, patient in supine position, 30 degrees, 4 mm Arthroscopic manipulation. Non-invasive traction.