Posterior ankle and hind foot arthroscopy - how do you responsibly learn this new technique?

Posterior ankle and hind foot arthroscopy has become an important diagnostic and therapeutic tool when dealing with ankle pathology. Although not yet widely adopted it is gaining popularity and there have been various descriptions of the technique [1] and its outcomes [2,3]. With posterior arthroscopy there are well-documented risks of injury to the sural nerve and medial neurovascular bundle in particular [7-9]. These risks need to be carefully considered, particularly by surgeons early in the learning curve of what is undoubtedly a challenging technique. In an ideal world there should be scope for regular simulation to be integrated into a consultant's working week and this would allow them to be prepared for untoward incidences and also learn new techniques such as hind-foot arthroscopy in a safe environment prior to introduction into clinical practice.