Arthrosis of the ankle joint, typically posttraumatic in nature, can affect younger and older populations alike. A multitude of procedures exist for treatment, such as arthrodesis, total joint replacement, arthrodiastasis, and articular repair. Current literature has demonstrated success in articular surface repair and arthrodiastasis as separate procedures. This article reviews the technique of ankle arthrodiastasis and interpositional ankle exostectomy, consisting of background, mechanism of action, indications, patient selection criteria, complications, and advantages in the current literature.