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Purpose: This study aimed to investigate anterior knee symptoms in patients who underwent anterior cruciate ligament (ACL) reconstruction using bone­patellar tendon­bone (BPTB) graft followed by implantation of a beta­tricalcium phosphate (β­TCP) block as a bone void filler.Materials and Methods: We retrospectively reviewed 84 cases of synthetic bone grafting using a β­TCP block for the patellar bone defect in ACL reconstruction with a BPTB autograft. Computed tomography of the operated knee was performed immediately after the surgery to evaluate whether the grafted β­TCP block protruded forward from the anterior surface of the patella. On the basis of the results, the cases were divided into a protrusion group (n=31) and a non­protrusion group (n=53). Anterior knee symptoms at 12 months postoperatively and absorption of the grafted β­TCP block were compared between the two groups.Results: Except for patellofemoral crepitus, there was no significant difference in anterior knee symptoms between the two groups (p>0.05). The incidence of patellofemoral crepitus was significantly lower in the protrusion group than in the non­protrusion group (p=0.027). The groups showed no significant difference in β­TCP absorption.Conclusions: The present study demonstrated that the protrusion of β­TCP that was used as a bone void filler had no adverse effects.

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