Patella tendon harvest for ACL reconstruction


Subscribe to get full access to this operation and the extensive Knee Surgery Atlas.


Learn the Patella tendon harvest for ACL reconstruction surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Patella tendon harvest for ACL reconstruction surgical procedure.

The ideal graft for ACL reconstruction should be widely available and easily procured.  It should have mechanical properties equal to those of the native ligament and it should allow secure fixation to enable aggressive rehabilitation.  It should also incorporate rapidly and have limited donor site mobility.  It should have a low probability for disease transmission or immune rejection.  It should also be inexpensive.

The ideal graft does not exist with all grafts requiring degrees of compromise.  Without doubt hamstring autograft has become the most popular ACL graft globally over the last 10years for a number of reasons. It is easier to harvest through small cosmetic scar and lends itself to “all inside” techniques.  ACL reconstruction with bone patella bone(BTB) still has a significant role and is particularly favoured in elite athletes as well as for revision surgery.  The bone blocks allow for more aggressive early rehabilitation suiting the elite athlete with a lower rerupture rate in this population reported.

A recent study by Gabler et al in the American Journal of Sports Medicine has shown that the rupture rate for BTB in anatomic ACL to be comparative to hamstring.  BTP knees had a greater incidence of anterior knee pain and crepitus, where there was a tendency towards increase laxity within the hamstring group.  Clinical outcomes showed no differences.  The long-term outcome of bone patella bone ACL reconstruction has been reported by Pinczewski.  90 BTP ACLs were reviewed at 20 years post-surgery.  A 9% failure rate was reported on the index limb with a 30% rupture rate on the contralateral limb.  Knee pain was present in 63%.  Female patients although had a lower failure rate, they reported poorer IKDC scores had more activity-related pain and were less likely to participate in strenuous activities compared to males.  Thus, bone patella bone may well have more significant donor site mobility long term than hamstring tendon in females.


Author: Professor Martyn Snow FRCS(Tr & Orth)

Institution :The Royal Orthopaedic Hospital, Birmingham ,UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


  • Did you find this technique helpful?
  • YesNo

Lessons Status


Logo Logo Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo Logo