BTB is an abbreviation of bone-tendon-bone, and usually refers to a tendon graft from the patellar tendon, where each end of the removed graft is still attached to a piece of bone.

Page updated March 2024 by Dr Sheila Strover (Clinical Editor)

B-T-B graft harvest from patellar tendon
Illustration of the front of the knee joint to show where the B-T-B graft is harvested from.

 

What is a B-T-B graft used for?

A bone-patellar tendon-bone (B-T-B) graft is generally used to replace a torn anterior cruciate ligament. The bony ends of the preparation are useful in allowing fixation devices to firmly attach the graft into the new position.

 

  • Quote from peer-reviewed paper:

    "...The central-third of the native patellar tendon is a reliable graft and is the preferred option for competitive athletes given its excellent track record with high return-to-play rates and low failure rates...."

    Citation: Frank RM, Higgins J, Bernardoni E, Cvetanovich G, Bush-Joseph CA, Verma NN, Bach BR Jr. Anterior Cruciate Ligament Reconstruction Basics: Bone-Patellar Tendon-Bone Autograft Harvest. Arthrosc Tech. 2017 Jul 31;6(4):e1189-e1194. doi: 10.1016/j.eats.2017.04.006. PMID: 29354416; PMCID: PMC5621981.

Back to top

 

Advantages and disadvantages of B-T-B graft

The B-T-B graft is strong and the bony ends allow good fixation and consolidation when it replaces the anterior cruciate ligament. However, there may be considerable discomfort at the harvest site and exceptionally the patellar tendon may rupture.

 

Back to top

 

Healing after B-T-B graft harvest

The surgeon may choose to bone graft the patellar and tibial harvest sites pre-emptively to speed up bone healing and reduce post-operative anterior knee pain.

Back to top

 

Synonyms: 
B-PT-B
bone-tendon-bone
bone-patellar tendon- bone
patellar tendon graft
-

Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...