Technique: bone-patellar tendon-bone autograft ACL reconstruction in the young, active patient

Successful treatment of the anterior cruciate ligament tear in the young, active population can be reliably achieved with an arthroscopic bone-patellar tendon-bone (BTB) autograft reconstruction. Although some contraindications exist, the BTB autograft has been proven to provide for a durable, stable, and highly functional knee. Complications associated with the use of BTB can occur, but measures can be taken to minimize these risks. In addition to appropriate graft selection, meticulous surgical technique is required. This article outlines the step-by-step surgical technique including graft harvest, tunnel placement, graft preparation and passage, and interference screw fixation. Potential complications and the surgical decision-making options incurred are also discussed in detail.