Table 1.

Pearls and Pitfalls of Arthroscopic LT Reconstruction

Pearls	Pitfalls
Careful patient selection is warranted.	Ensure that the graft is prepared before acetabular drilling, to provide quicker placement to minimize fluid entry into the pelvis and the chance for abdominal compartment syndrome.
Cadaveric models should be used before surgery.	Avoid penetrating the medial acetabular cortex with the guidewire during guidewire placement in the fossa.
Femoral tunnel: A free-hand technique is used under fluoroscopy or with an aimer device.	Avoid plunging into the pelvis during acetabular rimming.
Acetabular tunnel position: Internal rotation and abduction are required for correct tunnel placement. The tunnel must be in the most inferior part of the acetabular fossa but angled away from the obturator vessels.	During acetabular fixation with the RetroButton, avoid flipping the button too early and ensure that the button is secure to avoid loosening.
Acetabular tunnel drilling: The guidewire should be advanced to the second cortex without penetrating it; care is used while reaming.	Avoid over-tightening the graft.
Upon drilling the 2 tunnels, the graft should be passed as soon as possible to prevent fluid accumulation in the pelvis.
Acetabular graft fixation: Passing and flipping the cortical button are challenging. Once the button has been flipped and secured, fluoroscopy should be used for verification.
Rehabilitation: The patient is placed in a hip brace. Physical therapy is started on the first postoperative day, refraining from abduction and external rotation the first 6 wk.