Table 1.

Pearls and Pitfalls

Pearls	Pitfalls
A 3/8-inch osteotome is ∼10 cm in width and can be used to size the graft	Don’t narrow the soft tissue aspect of the graft when making the knife cuts
Cutting the graft in a similar fashion to BTB autograft harvest will allow the surgeon to use familiar techniques for graft preparation	Let the saw “do the work” when cutting; if the graft isn’t completely thawed, cutting can be difficult if you rush, possibly fracturing the bone blocks
The vertical relief cuts in the bone blocks allow for easy delivery of the bone plug	Use a stack of towels to avoid “plunging”
Pass the #5 Ethibond by hand with needle off, as the needle is usually too wide to fit through the drill holes	Avoid the use of bone crimpers, as they can fragment the allograft bone; instead, shape the plugs with the rongueur
Make sure the patellar plug is an easy 10 and the tibial plug is an easy 11	Do not leave any prominent edges that can prohibit easy graft passage
Measure and record the plug and soft tissue lengths to avoid graft–tunnel mismatch	Make sure to request size-appropriate grafts based on patient height

BTB, bone–patellar tendon–bone autograft.