Table 1 Common pitfalls during DCX registration and the strategies to avoid them

Distal femur Schanz pins and/or the osteophytes along the proximal edge of the trochlea might hinder cutting block adapter placement

Pins should be inserted proximally enough, and the osteophytes should be removed completely

Synovial tissue and the fat pad covering the distal femur anterior cortex interferes with cutting block adapter placement

Soft tissue covering the distal anterior cortex should be incised in the midline and reflect either side meticulously using electrocautery and periosteal elevator

Flaps of the surgical wound could impinge on the cutting block adapter, affecting the accuracy of DCX registration

Soft tissue flaps should be retracted adequately