All patients will be randomly assigned using a computer randomization algorithm to one of two matched cohort groups. Patients will not be advised which group they belong to until after the completion of the study. One group will be treated with autologous bone graft for bone patellar-tendon bone (BTB) Anterior Cruciate Ligament Reconstruction (ACLR), and the other group will be treated with commercially available DBM (Demineralized bone matrix) putty. Patients will be enrolled from Banner University. Before and after surgery, patient reported outcomes including visual analog pain scale (VAS), Tegner-Lysholm and Cincinnati ACL Test. The principal investigator will evaluate the patients on subjective criteria such as pain and objective criteria including range of motion, arthritic changes seen on radiographs, infection, and ability to kneel.

Inclusion Criteria:

• 18-40 years old,
• male/female/gender neutral,
• all races not including vulnerable/special consideration populations,
• candidate for anterior cruciate ligament reconstruction with bone patellar bone autograft,
• compliant post operative course.

Exclusion Criteria:

• < 18, >41 years of age,
• prior bone patellar bone anterior cruciate ligament reconstruction,
• non-compliance post-operatively,
• nicotine dependence.