Table 1.

Pearls and Pitfalls

	Pearls and Pitfalls
Semitendinosus graft	The graft needs to be large enough to suitably pass through the scapular neck and allow fixation on the humeral head.
Scapular neck perforation	This is the most important step of the described technique. A minimal distance of 7-8 mm is required to avoid articular damage and fracture.
Cleaning of space	Suitable cleaning of the shoulder is needed to allow appropriate visualization of the entire articulation, as well as the scapular neck. Cleaning of the anterior exit point area needs to be highlighted to confirm its correct location and to preserve the subscapularis.
Humeral perforation	The location is 1 cm from the footprint, within the cartilage of the humeral head nearest the central line perpendicular to the middle of the footprint.
Direction	The direction of the perforation needs to be as anterior or anterolateral as possible to avoid the neurologic structures of the arm.