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Purpose: To quantify the maximum load to fracture in patellae from which bone-patellar tendon-bone (BPTB) and bone-quadriceps tendon (BQT) autografts have been harvested for anterior cruciate ligament reconstruction in a cadaveric model., Methods: Forty-six fresh-frozen patellae were isolated and divided into the BPTB harvest and BQT harvest groups with matching based on donor age and sex. Computed tomography scans were obtained to calculate bone mineral density (BMD) and patellar height, width, and thickness. BPTB and BQT grafts were harvested from the inferior patella and superior patella, respectively, and then ramped to failure in a 3-point bend test configuration to simulate a postoperative fracture produced by a direct impact after a fall. The presence of fracture, fracture pattern, and maximum load to fracture were recorded. Donor demographic characteristics; patellar height, width, and thickness; and maximum load were compared by the Student t test. Pearson correlations were used to determine whether maximum load was affected by BMD or patellar morphology. The level of significance was set at P < .05., Results: Maximum load to fracture was not significantly different ( P  = .91) between the BPTB (5.0 ± 2.3 kN) and BQT (5.1 ± 2.6 kN) groups. Maximum load to fracture in the BPTB group did not correlate with BMD ( P  = .57) or patellar measurements ( P  = .57 for thickness, P  = .43 for width, and P  = .45 for height). Maximum load to fracture in the BQT group positively correlated with BMD and negatively correlated with patellar height. Maximum load to fracture in the BQT group did not correlate with patellar thickness or width. Fracture through the harvest site was observed in 87% of BPTB specimens and 78% of BQT specimens., Conclusions: The location of the BPTB or BQT autograft harvest site did not significantly affect patellar load to fracture in a cadaveric model., Clinical Relevance: It is important to understand patellar morphology and the effect of BPTB and BQT graft harvest-site locations on the biomechanical strength of the patella after anterior cruciate ligament reconstruction., Competing Interests: The authors report the following potential conflicts of interest or sources of funding: S.S.B. receives personal fees from Exactech and grant support from Peerless Surgical, 10.13039/100009026Smith & Nephew, and 10.13039/100008894Stryker, outside the submitted work. G.E.O. receives personal fees from Exactech and grant support from Peerless Surgical, outside the submitted work. S.A.M. is an equity holder in AGelity Biomechanics, outside the submitted work. K.S. receives personal fees from Medical Device Business Services and DePuy and grant support from 10.13039/100007307Arthrex and Gotham Surgical Solutions & Devices, outside the submitted work. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material., (© 2023 The Authors.)

Recall bias is a systematic error caused by inaccuracy in reporting past health status and can be a substantial methodological flaw in the retrospective collection of data. Little is known about recall bias following anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to evaluate patients' recall bias regarding preinjury knee function at 2 years after ACLR., Methods: Patients undergoing ACLR were enrolled in an institutional ACL registry. Preoperatively and at 2 years postoperatively, patients quantified their preinjury knee function on a scale of 0 to 10 (10 = best). Recall bias was quantified as the difference in the reported preinjury function between the 2 time points. The clinical result of ACLR was evaluated according to the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation score. Patients meeting the minimal clinically important difference (MCID) in the IKDC score were considered to have had a good outcome, while patients who did not reach the MCID were considered to have had failure of treatment. Recall bias was compared between the 2 groups., Results: Of 2,109 patients enrolled in the registry, 1,219 were included in the study. Patients with a good outcome remembered their preinjury knee function on a 0-to-10 scale to be better than what they reported at baseline, by a mean difference of 0.40 points (95% confidence interval [CI], 0.22 to 0.58 points). The recall bias was stronger for patients with a poor outcome, who remembered their knee function to be worse than reported at baseline, by a mean difference of -0.81 (95% CI, -1.4 to -0.26). The mean difference in recall between the 2 groups was -1.21 (95% CI, -1.74 to -0.67) (p < 0.0001)., Conclusions: The recall bias of preinjury knee function following ACLR was small and not clinically meaningful for the majority of patients. However, patients with a poor outcome had a clinically relevant and significant recall bias., Clinical Relevance: Our findings suggest that patients with a poor outcome have a substantial recall bias. This has clinical relevance when considering treatment effects of revision surgery, whereby the clinical benefit of the treatment might be affected by recall bias., Competing Interests: Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A264)., (Copyright © 2021 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved.)