. 2022 Oct 20;11(11):e1889–e1895. doi: 10.1016/j.eats.2022.07.001

Table 1.

Pearls and Pitfalls

Pearls	Pitfalls
• Drill holes should be made around the bone blocks to prevent fractures when the bone blocks are removed. • Mark the junction between the tendon and each bone block with a sterile marker pen to ensure the bone blocks are positioned correctly following graft passage. • Initially use a 6-mm reamer when creating the femoral and tibial tunnels to enable adjustments if required. • Reamings can be collected during reaming of the tibial tunnel to add to the harvest sites at the end of the procedure. • When passing the graft, position the clamp proximally on the bone block to be able to turn around the condyle.	• Occasionally, graft passage is difficult due to the size of the bone block, particularly at the intra-articular entrance of the femoral tunnel. A probe can be used to assist the graft passage. • Ensure the tibial bone block is inserted in the femoral tunnel with the cortex face posteriorly to avoid difficult graft passage.

Pearls

Pitfalls

•
Drill holes should be made around the bone blocks to prevent fractures when the bone blocks are removed.
•
Mark the junction between the tendon and each bone block with a sterile marker pen to ensure the bone blocks are positioned correctly following graft passage.
•
Initially use a 6-mm reamer when creating the femoral and tibial tunnels to enable adjustments if required.
•
Reamings can be collected during reaming of the tibial tunnel to add to the harvest sites at the end of the procedure.
•
When passing the graft, position the clamp proximally on the bone block to be able to turn around the condyle.

•
Occasionally, graft passage is difficult due to the size of the bone block, particularly at the intra-articular entrance of the femoral tunnel. A probe can be used to assist the graft passage.
•
Ensure the tibial bone block is inserted in the femoral tunnel with the cortex face posteriorly to avoid difficult graft passage.