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Knee Videos: Tendon
Endoscopic Management of Osgood-Schlatter Disease
Osgood-Schlatter disease is a common cause of anterior knee pain in sports-practicing adolescents. The long-term outcomes have not always been favorable, and some adolescents have persisting knee pain into adulthood. Excision of the ossicle together with debridement of the tibial tuberosity is indicated if the pain is not relieved with conservative measures. An endoscopic technique for excision of the ossicle associated with Osgood-Schlatter disease is reported. It has the advantages of avoidance of painful surgical scars and preservation of the integrity of the patellar tendon, with the potential for improved cosmetic and functional results.Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis
Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus.Arthroscopic Biceps Tenodesis From a Superior Viewing Portal in the Shoulder
The purpose of this report is to describe our modification of the Verma-Trenhaile biceps tenodesis technique using a superior viewing portal that allows placement of the tenodesis site at the top of the pectoralis major tendon with interference screw fixation. The advantages of this technique include the following: (1) There is no need to exteriorize the tendon through the skin. (2) Viewing from superiorly allows a panoramic view of the groove all the way to the pectoralis major tendon insertion.Endoscopic Resection of Gouty Tophus of the Patellar Tendon
Tophaceous deposition of tendon can result in spontaneous patellar tendon rupture. Surgical therapy may be needed to control symptoms and prevent tendon rupture. Open debridement of the lesion requires a lengthy incision over the lesion; this may result in symptomatic scar adhesion of the patellar tendon or an unhealed wound with persistent tophaceous discharge. Moreover, the other part of the patellar tendon cannot be examined through the incision. We describe a technique for endoscopic resection of a gouty tophus of the patellar tendon.Endoscopic Resection of Lipoma of the Patellar Tendon
Synovial lipoma of the patellar tendon is a very rare entity. It can be associated with rupture of the patellar tendon. We present a case of synovial lipoma that was successfully resected endoscopically. The other indications for patellar tendoscopy include chronic patellar tendinitis and tendinosis, recalcitrant bursitis around the tendon, Osgood-Schlatter disease, and jumper's knee. The major potential danger of this endoscopic procedure is iatrogenic damage to the patellar insertion during endoscopic debridement in patients with jumper's knee or the tibial insertion during endoscopic debridement in patients with Osgood-Schlatter disease.
