Table 1: Surgical Technique.
| 1. Autograft gracilis and semitendinosus hamstring tendons are harvested in the standard fashion using a closed-ended tendon stripper, cleaned of muscle tissue and whip-stitched with a # non-absorbable suture at each end |
| 2. A 6.5 mm transverse tibial tunnel is created using a guidewire 1 cm posterior to the tibial tubercle |
| 3. Any remaining healthy patellar tendon is preserved |
| 4. The semitendinosus and gracilis tendons are passed through the transverse tibial tunnel |
| 5. Semitendinosus autograft is delivered to the inferior pole of the patella in a crisscrossed pattern and weaved into the remnant of healthy patellar tendon |
| 6. Gracilis autograft is delivered to the inferior pole of the patella in a U-shaped pattern |
| 7. Autograft tissue is docked into two 6.5 mm by 20 mm patellar sockets in the inferior lateral aspects of the patella and secured with Bio-Compression screws |
| 8. Inferior medial patellar socket is secured first before moving to the lateral patellar socket |
| 9. A 6.25 mm Bio-Compression screw provides interference fixation in the transverse tibial tunnel |