Table 2.

Pearls and Pitfalls

Pearls	Pitfalls
Correct identification of the adductor tubercle is important to perform the correct skin incision.	Overtensioning the graft can cause loss of range of motion and patellofemoral arthrosis, leading to residual pain.
Careful dissection of the insertion of the adductor magnus tendon to avoid proximal graft placement and consequently a nonanatomic insertion of the medial patellofemoral ligament.	Not recognizing other anatomical predisposal factors for patellar instability may lead to potential failure.
When performing the harvesting of the semitendinosus and gracilis tendons, care must be taken to avoid stripping the tendons. A tendon length of 22 cm is needed for reconstruction.
Placing the surgical string loop around the adductor magnus tendon insertion site will help in the later passage of the autografts
Appropriate tension is required in the patella and quadriceps tendon during the suture of the grafts to avoid loosening or overtension.