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The senior author developed this single-incision arthroscopic-assisted procedure for patellar tendon graft reconstruction of the anterior cruciate ligament nearly 10 years ago. Over time, we have been able to obtain consistently good results. The advances of this procedure include safety with graft harvest and reduction in patient morbidity, allowing patients to return to their desired activity level with near-normal knee stability and strength. The success of this operation depends on the surgeon's systematic completion of each step and the use of intraoperative radiographs before moving on to the next step.