Bone–Patellar Tendon–Bone Graft Explained

The graft is commonly taken from the middle portion of the patient’s patellar tendon, with a small bone plug from the kneecap and another from the shinbone. The plugs are secured in bone tunnels so the graft can function as the reconstructed ligament.

Because the graft has bone at both ends, healing occurs where each bone plug meets its tunnel. The surgeon selects graft type according to knee anatomy, activity goals, previous operations and the condition of the patellar tendon. This option uses the patient’s own tissue, so it also creates a healing area at the front of the knee.

Possible trade-offs include pain while kneeling, tenderness near the harvest site, stiffness, or weakness during early rehabilitation. Individual risks depend on the operation and health history.

Follow the surgeon’s instructions for wound care, brace use, crutches and weight bearing. Take prescribed medicines as directed and use cold therapy only with a protective layer between the cold source and skin. Keep scheduled physiotherapy appointments.

Rehabilitation usually progresses from controlling swelling and restoring knee extension to strength, balance and movement training. Do not advance running, pivoting or sport merely because pain has eased; graft healing and movement quality guide progression.

Contact the surgical team promptly for increasing redness, wound drainage, fever, worsening swelling, pain that is not controlled, or a new loss of knee movement. Urgent assessment is needed for chest pain, difficulty breathing, sudden calf pain or swelling, a cold or pale foot, or new numbness or weakness.

A new twist, fall, pop or episode of the knee giving way should also be reported, particularly if followed by rapid swelling or inability to bear weight.

Discuss why this graft suits your knee, where the tissue will be taken from, how fixation will be performed, and how previous knee problems affect the choice. Ask for clear milestones for driving, work, kneeling and sport, plus the plan if stiffness or harvest-site pain develops.