Endoscopic Surgical Removal of Calcific Tendinitis of the Rectus Femoris: Surgical Technique  Fernando Comba, M.D., Nicolás S. Piuzzi, M.D., Gerardo Zanotti, M.D., Martín Buttaro, M.D., Francisco Piccaluga, M.D.  Arthroscopy Techniques  Volume 4, Issue 4, Pages e365-e369 (August 2015) DOI: 10.1016/j.eats.2015.03.022 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 Preoperative (A) anteroposterior and (B) lateral radiographic views of the right hip show calcification near the superior lip of the acetabulum (arrows). Postoperative (C) anteroposterior and (D) lateral views show complete resection of the calcification after endoscopic surgery. Arthroscopy Techniques 2015 4, e365-e369DOI: (10.1016/j.eats.2015.03.022) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 With the patient placed in the supine position on a traction table with the limb in 15° of abduction and neutral rotation without traction, (A) an anteroposterior fluoroscopic image and (B) clinical photograph show the conventional anterolateral portal being established with introduction of a 15-gauge spinal needle pointing directly to the calcific lesion. Arthroscopy Techniques 2015 4, e365-e369DOI: (10.1016/j.eats.2015.03.022) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 (A) An anteroposterior fluoroscopic image shows a cannula trocar assembled in the anterolateral portal through a nitinol wire inserted through the previously established spinal needle. Subsequently, a second spinal needle is placed through a proximal accessory hip arthroscopy portal aiming toward the calcific lesion under fluoroscopic control and direct visualization. (B) An anteroposterior fluoroscopic image and (C) clinical photograph show both portals after establishment. Arthroscopy Techniques 2015 4, e365-e369DOI: (10.1016/j.eats.2015.03.022) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 4 Extracompartmental arthroscopic views in a right hip (70° arthroscope in anterolateral portal and shaver in proximal accessory portal). (A) The endoscopic view shows resection, with a shaver, of the soft-tissue layer that surrounds the calcific tendinitis lesion (asterisks), generating a space around it. (B) Afterward, radiofrequency ablation is used to perform hemostasis and local bleeding control. Arthroscopy Techniques 2015 4, e365-e369DOI: (10.1016/j.eats.2015.03.022) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 5 After the full extension of the lesion has been established, the bone lesion is resected with a 5-mm round burr, switching the portal placement to facilitate the whole lesion resection. (A) Anteroposterior fluoroscopic image with bone resection in progress with 5-mm burr, (B) clinical photograph showing portal switch, and (C) endoscopic view showing lesion resection with 5-mm burr. The asterisk depicts the bone calcific lesion. Arthroscopy Techniques 2015 4, e365-e369DOI: (10.1016/j.eats.2015.03.022) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions