*4.10.3 Step 3: Medial Patellar Dissection With Suture Anchor Placement and Bone Debridement*

Next, a longitudinal incision is made over the medial border of the patella, and dissection is carried out down to the level of the capsule. A longitudinal arthrotomy is performed just medial to the patellar tendon. The proximal-third of the medial aspect of the patella is debrided with a rongeur down to a base of bleeding bone, creating a footprint for insertion of the gracilis tendon graft. Two GRYPHON suture anchors (DePuy Mitek) are placed in the medial aspect of the patella: the first suture anchor at the junction of the proximal-third and middle-third of the medial border of the patella, and the second suture anchor, 5 mm to 10 mm proximal to the first (**Figure 8**).
