Patients with anterior ankle impingement often require surgical resection of bony spurs and soft tissue impingement, traditionally achieved via open or arthroscopic anterior ankle debridement in an OR. Building on older designs of an alternative known as in-office needle arthroscopy (IONA), John G. Kennedy, MD, and colleagues at NYU Langone Health have pioneered a minimally invasive nano-arthroscopy system (the NanoScope™ system).

In a new study, published in Arthroscopy, Dr. Kennedy’s team and collaborators in the Netherlands evaluated the clinical outcomes and patient experience of 31 athletic individuals who underwent the IONA procedure for an anterior ankle impingement. They found that all patients who had worked prior to the IONA procedure returned to work, and 26 of 27 patients returned to their sports activities. These results are far superior to those from open or traditional arthroscopic procedures.

“I think we are heading toward a time when visiting an orthopedic surgeon will be more like visiting your dentist.”

John G. Kennedy, MD

Overall, the IONA alternative resulted in significant pain reduction, a low complication rate, and excellent patient-reported outcomes.

“I think we are heading toward a time when visiting an orthopedic surgeon will be more like visiting your dentist—you’ll go in for a small procedure under local anesthetic and expect to leave on the same day,” Dr. Kennedy says.


Dr. Kennedy has received support from the Ohnell Family Foundation and Mr. and Mrs. Michael J. Levitt; he is also a consultant for Arteriocyte Industries (Isto Biologics) and Arthrex®, which produces the NanoScope™.