Anterior Cruciate Ligament Reconstruction Basics: Bone–Patellar Tendon–Bone Autograft Harvest

Anterior cruciate ligament reconstruction with bone–patellar tendon–bone autograft has long been considered the graft preference for young, active patients with anterior cruciate ligament injuries. The central-third of the native patellar tendon is a reliable graft and is the preferred option for competitive athletes given its excellent track record with high return-to-play rates and low failure rates. Disadvantages to using this graft include donor site morbidity and associated postoperative anterior knee pain, the risk of patellar fracture or patellar tendon tear, and the potential for graft-construct mismatch. In this Technical Note, we describe our preferred technique for bone–patellar tendon–bone autograft harvest and preparation for anterior cruciate ligament reconstruction.