Figure 2. Lateral to medial approach to patellar tendon.

A. Short axis image of the patellar tendon (arrowheads) showing the TX device (arrows) advanced through the lateral tract created by the #11 blade and positioned just deep/posterior to the lateral patellar tendon fibers. The device is then used to debride the adherent fatty tissue as it is advanced into the region of degenerative tendon (+) which is then debrided. B. Long axis image of the patellar tendon (arrowheads) shows an out of plane view of the TX device microtip positioned within the hypoechoic degenerative tissue (+). Using both in plane and out of plane imaging relative to the device throughout the procedure is helpful to determine adequate treatment of the entire pathologic region of tendon while also avoiding the healthy superficial fibers. PAT = patella, PROX = proximal, MED = medial.