Table 1.

Pearls and Pitfalls

Step	Pearls	Pitfalls
Mobilization of bony avulsion and preparation	Panoramic view is obtained of the fracture site arthroscopically	Sometimes difficult to mobilize the fractured bone arthroscopically
Posterior anchor placement	Posterior fixation to the fracture gives more anatomic reduction and more stability	Technically demanding to place the anchor; needs an accessory portal
Suture passing	Sutures are passed through the bone and ACL itself anteriorly and posteriorly	Technically demanding to pass suture through the bone; needs special instruments to pass the suture (suture lasso); requires use of a cannula (increased cost)
Placement of the anterior anchor	Adds more stability and anatomic reduction	Extra cost; difficult visualization of the anterior cortex below tibial plateau; should be a knotless anchor