Endoscopic Resection of Gouty Tophus of the Patellar Tendon

Abstract

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. It has the advantage of small incisions away from the lesion and tendon and minimizes wound problems. The whole patellar tendon can be examined endoscopically.

Endoscopic Resection of Prepatellar Bursa

“…If knee arthroscopy, patellar tendoscopy, or endoscopy of the Hoffa fat pad is needed, the standard anterolateral and anteromedial portals can be used for the bursoscopy, arthroscopy, tendoscopy, and endoscopy. [15][16][17] We consider septic bursitis as a relative contraindication of the endoscopic bursectomy. If one wants to perform endoscopic resection of an infected prepatellar bursa, precautions should be taken to prevent spreading of bacteria, such as avoidance of use of an Arthropump, adequate antibiotic cover, and insertion of a suction drain.…”

Endoscopic Resection of Avulsed Fragment of Tibial Tuberosity and Endoscopic-Assisted Repair of Patellar Tendon

“…Patellar tendoscopy has been used to treat chronic patellar tendinitis and tendinosis, 12,13 recalcitrant bursitis around the tendon, 14 Osgood-Schlatter disease, 15 jumper's knee, 16,17 gouty tophus, 18 and synovial lipoma of the tendon. 19 Our endoscopic technique follows the same surgical principles of debridement, bone resection, and tendon repair as in an open procedure.…”

“…20,21 The use of small portal incisions that are not directly over the patellar tendon can avoid these complications. 17,18 Moreover, the use of endoscopy can allow examination of the whole tendon, similar to open exploration of the tendon. Precise debridement under arthroscopic guidance hopefully can reduce the surgical trauma to the tendon.…”

Endoscopic Decompression of a Gouty Tophus at the Hand Dorsum

“…Endoscopic resection of a gouty tophus has been reported in the foot 10 and knee. 11 The tophi can be adequately decompressed without wound, tendon, or neural complications. 10,11 Besides minimization of wound complications, it has the advantage of debridement under direct endoscopic visualization and reduces the risk of injury to the underlying tendon and neurovascular bundles.…”

“…10,11 Besides minimization of wound complications, it has the advantage of debridement under direct endoscopic visualization and reduces the risk of injury to the underlying tendon and neurovascular bundles. 10,11 In this Technical Note, we report an endoscopic approach of debulking a gouty tophus at the hand dorsum. This technique is indicated for symptomatic gouty tophi of the hand dorsum.…”