To determine the distribution of intra-articular lesions according to age and gender by retrospectively examining the archive records of patients who were operated due to ankle instability. Methods: The patient records of ankle arthroscopy procedures from between February 2009 to February 2020 were retrospectively evaluated. The information about patients such as age, gender, surgical site, intra-articular and surrounding lesions (osteochondral defects, degenerative cartilage changes, synovial

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... isorders, impingement syndromes, flexor hallucis longus lesions and the presence of os trigonum) were noted and compared statistically. Results: The incidence of concomitant intra-articular pathology was found to be 78.2% in patients who underwent ankle arthroscopy due to instability. Anterior impingement syndrome in 74.5% of patients, osteochondral lesion in 41.2%, synovial hypertrophy in 15.8%, and degenerative arthritis in 9.1% of the patients were detected. The mean age of the patients with anterior impingement syndrome (p: 0.012), osteochondral defect (p: 0.001), and degenerative arthritis (p: 0.003) was found to be significantly higher than those without. The mean age of patients without additional pathology was 33.91±12.08, patients with an additional pathology were 37.77±12.35, and patients with more than one pathologies were found to be 42.15±11.79 (p: 0.003). Conclusions: The most important finding of this study was that the presence and number of pathologies accompanying ankle instability increased with age. Considering the incidence of concomitant lesions in patients to be operated due to chronic ankle instability, detailed evaluation of preoperative magnetic resonance imaging and performing diagnostic arthroscopy may be beneficial for determining the possibility of concomitant lesions.