Table 2.

Pearls and Pitfalls for Arthroscopic Labral Reconstruction of Hip Using Front-to-Back Fixation Technique and Iliotibial Allograft

Pearls

Normal traction is used.

The use of 3 portals is necessary to maintain graft tension.

The anterolateral portal is used to visualize the anterior acetabulum.

The anteromedial portal is used to visualize the posterior acetabulum.

The peripheral compartment should be used to access the anteroinferior joint out of traction.

The distal portal (DALA portal) should be used to place anchors.

The graft should be shuttled in traction through the DALA portal through the intact anteroinferior capsule.

Pitfalls

Use of excess traction

Loss of anterior capsule integrity

Inability to access entire acetabulum

Lack of meticulous graft preparation

Inadequate anchor placement with anchors not placed as close to edge of acetabulum as possible without penetrating subchondral bone

DALA, distal anterolateral accessory.