Table 2.

Pearls and Pitfalls

Pearls	Pitfalls
Perform a complete preoperative examination with the patient under anesthesia to evaluate the extent of posterior instability.	Failure to identify a HAGL lesion can result in lower outcomes. The presence of instability symptoms with a normal labral appearance should raise suspicion.
Verification of adequate patient positioning is needed to ensure optimal preoperative setup. Landmark identification and portal placement demarcation should be performed before starting the procedure.	Incorrect patient positioning may worsen visualization and reduce the ease of work.
Use a spinal needle with an outside-in technique previous to portal creation to verify proper working and viewing portals.	The axillary nerve might be at risk when working with shavers or hooks in the anteroinferior quadrant. Moreover, injury to the cephalic vein can occur with low percutaneous subscapularis anchor insertion.
Meticulous bony preparation with the aid of shavers and curettes is advocated to establish an optimal biologic environment of the repair.	Inadequate restoration of HAGL tension might lead to higher risk of recurrence.
The use of cannulas can facilitate the interchanging of the viewing and working portals with ease.	Because of the number and position of the anchors, suture tangling is a concern. Mindful suture managing should be carried out.
Verify a good bony apposition of the bony avulsion to its anatomic attachment in the humerus.	Allograft shaping errors can be detrimental to postoperative outcomes. Moreover, it would prolong surgical time and exposure.
Use of fresh allograft (less than 28 days after deceased) has been reported as important in consideration of chondrocyte vitality.
Careful measurement and shaping of the defect should be performed before molding the allograft to ensure a good press fit.

HAGL, humeral avulsion of the glenohumeral ligament.