To test the hypothesis that a template system for harvesting bone-patellar tendon-bone (BTB) would cause fewer postoperative patellofemoral problems than freehand graft harvests, two groups of 20 patients who had arthroscopically assisted anterior cruciate ligament (ACL) reconstructions were compared at 1 and 3 years. Three years after surgery, no significant differences were found in the quality of the ligament reconstruction. One intraoperative patellar fracture occurred in the freehand group (group 1). All other complications were similar between groups. Squatting profiles were slightly better in the template group (group 2). Averaged and outlier scores from three published patellofemoral scoring systems showed no significant differences between the two groups. It was concluded that current methods for measuring patellofemoral function detected little morbidity and no significant outcome differences between ACL reconstructions done with BTB grafts harvested by freehand versus templated techniques.