Reconstruction of the anterior cruciate ligament has been performed using a variety of materials. The use of patella tendon autograft has become increasingly popular, especially in the younger patient. There are, however, recognized complications using this technique: lack of full extension has been described in 7-24% of patients; anterior knee pain in 6-30% of patients; patella fracture; and patella tendon rupture. The way in which the graft is taken may account for some of these complications. Until now harvesting of the patella tendon graft has been by use of osteotomes or drills, with subsequent trimming of excess bone to allow introduction into the cylindrical bone tunnels. This will result in removal of an excess amount of bone from both patella and tibia. If this could be reduced, then such complications may also be reduced.A new graft harvester has been designed by Neoligaments which allows accurate removal of both bone plugs and patella tendon. The use of this new device is described. Early results from nine patients (between 1 and 11 months postoperative) are available: two patients are still undergoing rehabilitation; one patient describes generalized knee pain and has subsequently been found to have a lateral meniscus tear; one patient has symptoms of clicking near full flexion; and one patient has a 5° extensor lag. The results with this technique are encouraging and may provide a method of reducing some of the complications of anterior cruciate ligament reconstruction using the patella tendon.