Table 2.

Surgical Pearls and Pitfalls

Pearls	Pitfalls
The surgeon should perform diagnostic arthroscopy before opening the graft to ensure the patient is a candidate.	The graft should be oriented to prevent placing the wrong side down.
The inner (clear) sheath from the anterosuperior (Gemini) cannula is removed, leaving the blue outer sheath of the cannula in the joint. The outer sheath does not have a dam within it, thus allowing easy passage of the graft and sutures without resistance. Once the graft is inserted into the joint, the suture limb that tightens the knotless anchors is sequentially pulled from each anchor until all the slack is removed from each anchor.	Placement of microfracture holes too closely should be avoided.
If a suture cuts through the graft, a suture-shuttling device can be used to pass the suture limbs through the graft and reanchor it with a PushLock anchor (Arthrex).	Insufficient debridement and preparation of the cartilage borders and bony bed should be avoided.
The surgeon should use a probe to remove suture slack to avoid cutout from the graft.
Microfracture of the defect may be performed based on surgeon discretion.