Fig 2.

External view of bone–patellar tendon–bone graft during preparation. (A) The cylindrical patellar bone block, 15 to 20 mm in length, is shaped with a rongeur and rasp so that the tip just fits the entrance of a 9-mm template (black star) (or an 8-mm template when the 8.4-mm trephine has been used). (B) For further femoral backup fixation, a BTB TightRope is brought through a 2-mm drill hole at the center of the proximal bone block (black star). (C) Narrowing of the free end of the distal bone block (from the tibial tuberosity) is performed with an oscillation saw (black arrow) so that a trapezoid bone block is shaped (Fig 3). (D) The total length of the graft is determined after placement of 2 No. 2 FiberWire threads within the distal ligament and the trapezoid bone block (black arrow). The cylindrical femoral bone block is shown with the BTB TightRope (black star) in place.