Table 3.

Pearls and Pitfalls

Pearls	Pitfalls
•Harvest quadriceps tendon through longitudinal skin incision and in a proximal-distal fashion.	•Excessive length or depth in bone plug harvesting could lead to patellar fracture. •Inadequate technique for graft preparation at the tendon extremity (SpeedWhip rip-stop technique) could lead loosening of the tension.
•Patellar bone block should be a trapezoidal transverse section and no more than 2 cm in length to reduce the risk of patellar fracture.
•A metallic wire should be placed in the bone block to allow secondary fixation in case of extensive tibial tunnel widening.
•Out-in technique for femoral tunnel allow creation of new tunnel with low risk of tunnel convergence.
•Direct arthroscope inspection of tibial and femoral tunnel to check cleaning and any convergence with old tunnels.
•Anterolateral reconstruction or lateral extra-articular tenodesis can be easily performed, as the incision for graft harvest is away.