Simple Technique to Address Graft-Tunnel Mismatch in Bone−Patellar Tendon−Bone Anterior Cruciate Ligament Reconstruction

Graft-tunnel mismatch during anterior cruciate ligament reconstruction using bone−patellar tendon−bone autograft is a significant problem, and it is imperative that the orthopaedic surgeon knows how to address this intraoperatively. Graft-tunnel mismatch has been reported to be as high as 20% during anterior cruciate ligament reconstruction with bone−patellar tendon−bone autograft. We present a technique that is easily reproducible using a simple whipstitch for backup fixation after trimming the tibial-sided bone block that gives reliable tension on the graft without necessitating adjustment of femoral fixation.