Table 1.

Pearls and Pitfalls

Surgical Steps	Pearls and Pitfalls
Graft preparation	Make sure you have pulling strands in every portion of the proximal graft end; otherwise, you will struggle getting the midportion in the tibial tunnel. Afterwards, put the sutures under tension and mark the convex side as medial.
Femoral tunnel	Use the medial portal as a viewing portal after marking the desired position of the femoral tunnel to double-check the planned tunnel is in the correct position.
Tibial tunnel	Check the correct position of the tibial guide with a C-shape around the anterior horn of the lateral meniscus—further anterior than usual; otherwise, the anterior horn is at risk with dilating the tibial tunnel.
Graft insertion	Before insertion, meticulously clean up the tibial entrance to avoid soft-tissue interference with the graft and put the convex side of the graft looking medially. When the graft enters the joint, put the knee close to extension and you will obtain the right orientation of the graft automatically.
Tibial fixation	Always open the first 5 mm of the tibial tunnel using the large dilator to make sure the PSP sits in the tunnel properly and then tie the sutures and place the knot in the recess.

PSP, Pull Suture Plate.