Arthroscopic Treatment of Patellar Tendinopathy: Use of 70° Arthroscope and Superolateral Portal  Orestis Karargyris, M.D., M.Sc., Vipul Mandalia, M.B.B.S., F.R.C.S., F.R.C.S.(Tr&Orth)  Arthroscopy Techniques  Volume 5, Issue 5, Pages e1083-e1087 (October 2016) DOI: 10.1016/j.eats.2016.05.014 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 (A) Left knee arthroscopic view. The patellofemoral joint is viewed through the superolateral portal with a 70° arthroscope. The proximal patellar tendon pathology is visible (black arrow). (B) The T1 weighted image reveals marked thickening and increased signal intensity in the patellar tendon (red arrow). Arthroscopy Techniques 2016 5, e1083-e1087DOI: (10.1016/j.eats.2016.05.014) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 The surgeon is demarcating the coronal width of the left patellar tendon under direct visualization, with the 70° arthroscope placed in the superolateral portal. This is achieved by means of direct palpation of the tendon by the surgeon and inserting a needle at the most lateral and medial border of the tendon. Thus, the working area is recognized (left-right arrow) and the surgeon can proceed to debridement. This step is often advantageous because the inflamed tissue blocks the direct view to healthy patellar tendon. Arthroscopy Techniques 2016 5, e1083-e1087DOI: (10.1016/j.eats.2016.05.014) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Debridement of left proximal patellar tendon with straight arthroscopic shaver. This is achieved through the working anterolateral portal. (A) The procedure is performed under visualization with a 70° arthroscope placed in the superolateral viewing portal. The targeted, pathologic infrapatellar region is visible. The arthroscopic shaver is introduced through the working portal. (B) Debriding with swiping movements of the arthroscopic shaver from proximal to distal causes the healthy proximal patellar tendon to become visible. Viewing and working portals remain unchanged throughout the procedure. Arthroscopy Techniques 2016 5, e1083-e1087DOI: (10.1016/j.eats.2016.05.014) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Superolateral view of left patellar tendon through a 70° arthroscope. After decompression and removal of degenerative tissue, the healthy patellar tendon is visible (arrow). Arthroscopy Techniques 2016 5, e1083-e1087DOI: (10.1016/j.eats.2016.05.014) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions