Arthroscopic treatment of posteromedial impingement utilizes a straight posterior and posterolateral portals. The posterolateral portal is used as a working portal and the straight posterior portal is used for insertion of the arthroscope. After thorough arthroscopic evaluation of the posterior compartment and removal of any loose bodies, the posteromedial osteophyte is removed with a small osteotome taking care to remove bone fragments with a grasper. The remaining tip is finished with a small burr or shaver, only removing enough bone to allow full extension without impingement. Chondromalacia of the fossa is debrided of any unstable cartilage flaps and abrasion chondroplasty is performed if necessary.