Table 1.

Pearls, Pitfalls, and Complications

Pearls

The anterior portal should be established just distal to the anterolateral border of the acromion to facilitate coracoid exposure.

The suture-button construct should be introduced with a locking grasper to facilitate better control as the suture is being advanced through the tunnels.

A 70° arthroscope may be helpful for improved coracoid visualization and should be available.

Pitfalls

The clavicle-coracoid tunnel must be 3.0 mm to pass the suture construct.

The surgeon should ensure that the cannulated guidewire is centered on the coracoid and posterior to lessen the risk of fracture.

Implant preparation may be confusing the first time and can be performed in a laboratory or on a model before surgery.

Complications

We have experienced breakage of the Chia passing wire while attempting to pass the construct. In this instance a new Chia passing wire is passed and used to shuttle a FiberLink (Arthrex) for construct passage.