Background: Anterior cruciate ligament (ACL) injury alters knee kinematics, increasing the risk of secondary degenerative changes and long-term functional impairment. With an incidence of 74.6 cases per 100,000 people per year, ACL reconstruction (ACLR) is one of the most common surgical procedures in sports medicine. However, ACLR does not reduce the risk of developing patellofemoral osteoarthritis – frequently associated with anterior knee pain – but may even promote its onset, with a median prevalence reported in the literature of 36%. Clinical evidence of patellofemoral cartilage lesions during post-ACLR rehabilitation prompted this study, the aim of which is to assess whether any of the autologous grafts – patellar tendon with bone blocks (BPTB), quadriceps tendon (QT) and quadriceps tendon with bone block (QTB) – is associated with a higher risk of patellofemoral cartilage damage.