Tendoscopic Synovectomy of Tibialis Anterior Tendon of the Ankle

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Tendoscopic Synovectomy of Tibialis Anterior Tendon of the Ankle Jeffrey Chun Yin Lee, M.B.B.S.(HK), Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S. Arthroscopy Techniques Volume 7, Issue 12, Pages e1243-e1248 (December 2018) DOI: 10.1016/j.eats.2018.08.009 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. Three portals along the TAT are used for this procedure. The proximal portal (PP) is located at the proximal end of the tendon. The distal portal (DP) is at the level of the talonavicular joint. The middle portal (MP) is at the level of the anterior ankle joint line. Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. (A) The distal portal (DP) is the viewing portal, and the proximal portal (PP) is the working portal. (B) An endoscopic view shows synovectomy of the proximal portion of the TAT. (IS, inflamed synovium; SER, superior extensor retinaculum.) Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. (A) The proximal portal (PP) is the viewing portal, and the distal portal (DP) is the working portal. (B) An endoscopic view shows synovectomy of the distal portion of the TAT. (AS, arthroscopic shaver; IS, inflamed synovium.) Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 Tendoscopic synovectomy of left tibialis anterior tendon. The patient is in the supine position with the legs spread. Finger pressing on the arthroscopic light spot pushes the inflamed synovium toward the shaver blade. (DP, distal portal; PP, proximal portal.) Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. (A) The distal portal (DP) is the viewing portal, and the middle portal (MP) is the working portal. (PP, proximal portal.) (B) An endoscopic view shows synovectomy of the middle portion (MP) of the TAT. (IS, inflamed synovium.) Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 6 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. (A) The distal extrasynovial portion of the TAT is examined through the distal portal (DP). (B) An endoscopic view shows the distal extrasynovial portion of the TAT. Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 7 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. (A) The middle portal (MP) is the viewing portal, and the proximal portal (PP) is the working portal. (B) The distal muscle belly of the tibialis anterior muscle (TAM) is reflected by the arthroscopic shaver. The deep surface of the musculotendinous junction is examined. Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 8 Tendoscopic synovectomy of left tibialis anterior tendon (TAT). The patient is in the supine position with the legs spread. The distal portal is the viewing portal. The synovial portion of the TAT is examined for any residual inflamed synovium. Arthroscopy Techniques 2018 7, e1243-e1248DOI: (10.1016/j.eats.2018.08.009) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions