Six Percent Incidence of Graft-Tunnel Mismatch in Anatomic Anterior Cruciate Ligament Reconstruction Using Bone-Patella Tendon-Bone Autograft and Anteromedial Portal Drilling

Femoral Fixation Strength as a Function of Bone Plug Length in Anterior Cruciate Ligament Reconstruction Utilizing Interference Screws

“…22,23 The potential benefits of harvesting shorter plugs, likely more significant on the patellar side, include minimizing the stress riser and potential donor site morbidity, especially in smaller-statured patients. 24 Additionally, as many surgeons have gone to independent drilling of the femoral tunnel (anteromedial portal method 20,23 ), the femoral bone plug from the BPTB graft needs to be delivered around a more acute angle into the femoral tunnel. Longer bone plugs may make this technically more difficult.…”

“…18 Recent arthroscopy techniques suggest that many surgeons are utilizing shorter patella bone plugs (bone blocks of 15 mm lengths) in ACLR with BPTB. 20,21 Bone plug length has been shown to effect fixation stability in femoral and tibial porcine models, with < 10 mm plug lengths led to significantly reduced failure loads compared with plug lengths of 10-and 15-mm. 22,23 The potential benefits of harvesting shorter plugs, likely more significant on the patellar side, include minimizing the stress riser and potential donor site morbidity, especially in smaller-statured patients.…”