In-Office Needle Arthroscopy of the Knee With Lateral Parapatellar Retinacular Release

The lateral patellofemoral joint, composed of multiple soft-tissue structures, balances the knee by aiding patella tracking, stability, and force distribution. Arthroscopic lateral release is a well-described procedure that addresses patellofemoral knee pain and, in cases with patellar instability, may be combined with medial stabilization. In-office needle arthroscopy is an up-trending technique that simultaneously diagnoses and treats patellofemoral pathology in the office, leading to a quicker patient recovery, reduced cost, and improved patient satisfaction. The purpose of this Technical Note is to describe in-office needle arthroscopy technique to address patellofemoral pain and lateral patellar mal-tracking, with special consideration for achieving adequate local anesthesia, proper indications, adequate visualization, and the advantages of performing these procedures in the office rather than the operating room.