Table 2.

Pearls and Pitfall of the Technique

Surgical Steps	Pearls	Pitfalls
Identifying the bony landmarks	Recognition of the femoral LCL insertion site and genicular vessels will help in determining the best femoral extra-articular placement	Difficulty in identifying these individual points in bulky patients
Isometry testing	A suture is looped around the K-wire and the isometry tested through ROM	Inappropriate selection of isometric points results in great length variability throughout ROM
Graft harvest	While harvesting the ITB care should be taken not to cut the vessels posterior to the lateral condyle	Postop hemorrhage due to excessive bleeding from the severed vessels
Graft fixation	Maintaining the knee between 30° flexion and full extension while fixing the graft to the tibia	Inappropriate knee position while fixing the graft may lead to a nonisometric reconstruction
ITB closure	Tight closure of the fascia lata with a No. 2 suture at the end of the surgical procedure	Closure of the fascia lata using the Jaeger artifice13 may be helpful in cases of bulky vastus lateralis

ITB, iliotibial band; LCL, lateral collateral ligament; ROM, range of motion.