Table 1.

Pearls and Pitfalls of Percutaneous Repair of ACL Tears Using Needle Arthroscopy

Surgical Technique	Pearls	Pitfalls
Portal placement	Placing the portals just superior to the joint line will allow access to all parts of the joint.	Errant portal placement will make visualization and technique completion difficult.
Passage of ACL repair stitch	A stitch should be placed into each bundle, and passing the instruments should be limited to 1 pass through the ACL.	Passing the instruments through the ACL multiple times can result in damage to the native ACL tissue.
Fixation of ACL repair	Some slack should be maintained in the repair stitches prior to impacting the suture anchor into the femur.	Too much tension on the repair suture may result in tearing through the ACL remnant.
Fixation of suture tape augmentation	Fixating the suture tape in slight flexion can allow for optimal placement at the tibial insertion.	Errant superior-lateral portal placement may result in an inability to obtain the optimal angle for suture tape fixation.

ACL, anterior cruciate ligament.