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Despite the emergence of the Anterior Cruciate Ligament (ACL) reconstruction using autogenous patella tendon graft (PTG) as one of the most common procedures in sports medicine, scant information exists in the literature reviewing its many complications. While many authors discuss individual issues, compiling them and putting them into proper perspective remains. This is especially important for the young orthopaedist in determining if he/she is providing the standard of care for patients.We review the literature and divide the most common complications of using autogenous PTG's into five categories: Anterior knee pain, motion disorders, donor site/extensor mechanism problems, graft failure, and arthritis/global knee pain. Technical means of avoiding and remedying those problems that are correctable are reviewed as well.