Application of a Beta-Tricalcium Phosphate Graft to Minimize Bony Defect in Bone–Patella Tendon–Bone Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament (ACL) reconstruction with a bone–patellar tendon–bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone–patellar tendon–bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as removal of bony tumors, and have shown positive utility in improving anterior knee pain after ACL reconstruction. In this Technical Note, we describe the technique of placing a β-TCP graft in the donor graft site after bone–patellar tendon–bone ACL reconstruction. After standard arthroscopic ACL reconstruction, the β-TCP is appropriately sized with an osteotome and sagital saw before being placed into the patellar and tibial donor sites. A 0-Vicryl suture is used to suture the periosteum to secure the β-TCP graft at the donor sites. This described technique allows for appropriate sizing and secure placement of the graft to maximize bone regeneration at the donor site.