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Introduction Understanding and meeting the patients' preoperative expectations for anterior cruciate ligament (ACL) reconstruction (ACLR) is critical for achieving successful patient-centered outcomes. There is currently no standardized method to assess preoperative expectations of ACLR based on the patient-derived methods. The purpose of this study was to develop and test a patient-derived patient expectations survey specific to primary ACLR. We hypothesized that a valid and reliable patient-derived survey could be developed to measur