We describe an arthroscopic approach for the treatment of patellar chondral lesions with the patient in the supine position. This approach can be used to perform certain procedures such as matrix autologous chondrocyte implantation and autologous matrixeinduced chondrogenesis. It is possible to perform these arthroscopic techniques working at an angle perpendicular to the patellar joint surface. First, with the patient in the supine position, arthroscopic longitudinal sectioning of the lateral patellar retinaculum is performed, and the patella is reverted with the help of a Codivilla forceps. It is then possible to place the chondral surface perpendicular to the floor, and it can be accessed directly through a lateral parapatellar portal. Short-term follow-up has shown the benignity of opening the patellar retinaculum. This procedure reduces morbidity compared with the traditional open surgery.T he treatment of cartilage lesions in the patellofemoral compartment is controversial. A recent study showed poor results and a significant rate of complications related to standard techniques and a high rate of revision surgery.

As trauma is the leading cause of this condition it affects younger patients and should be able to ensure a near complete resolution and return to activity. Arthroscopic instruments and techniques have improved significantly over the last few years, and arthroscopic surgery is now widely used in the ankle joint. It has proven to be a