Table 3.

Pearls and Pitfalls of the Proposed Technique

Pearls

Patient selection is critical

When injecting local anesthetic, use “blow slow before you go” technique

Encourage patients to ask questions and engage them as active participant during procedure

Before making proximal portal, perform full diagnostic tendoscopy. Can place portal more proximal or distal depending on pathology (debriding accessory muscle or tendon tear proximally versus groove deepening distally

If needed, can give additional anesthetic to facilitate conversion to open procedure

Pitfalls

No anesthesia backup available in office (can consider performing in operating room to begin with to have anesthesia available in case general anesthesia induction required)

Not giving local anesthetic enough time to work

Risk of tissue necrosis with epinephrine (can keep phentolamine available)

Failure to fully evaluate for anatomic variants and sources of retrofibular groove overcrowding