Why is it taking longer for surgeons to find better ways to operate on ankles than on other joints like the knees and hips? I read that they don't like to do that smaller surgery where they use a camera and that this is only for the bigger joints.

The ankle is a complicated joint - it's small, like the wrist, but complicated because of its structure. While certain types of surgeries are easier to do on the larger joints, surgeons have to find ways to access the inside of the ankle without causing more damage.

Arthroscopy is a type of minimally invasive surgery that allows doctors to make tiny incisions in which they insert cameras on the end of long, thin instruments. These cameras allow the doctors to see inside the joint and even to perform surgery. The problem with the ankle is that while the front or anterior part of the ankle is easy to access, the back, or posterior isn't. Therefore, the surgeons have to know what approach to use for what part of the ankle.

There has been a great deal of progress in this area over the past 30 years and more and more ankle arthroscopies are being performed.