Table 4. Studies on post fixation in anterior cruciate ligament reconstruction.

Reference	Year	Study type	Study purpose	Conclusion
Weiss (12)	2019	Biomechanical study	Comparative biomechanical analysis of tibial fixation strength for ACLR with interference screw compared with screw post and washer, and compared with the associated fixation of both methods (hybrid fixation)	• Hybrid fixation group presented a significantly higher final stiffness in comparison
				• Higher yield load compared to the interference screw group
Zainal Abidin (38)	2021	Biomechanical study	Analyze the biomechanical effects of different types of fixators (cross-pin, interference screw, and cortical button) towards stability after ACLR	• Cross-pin was found to have optimum stability in terms of stress and strain at the femoral fixation site
Speziali (39)	2014	Systematic review	Systematically review the fixation techniques for the ACL reconstruction and associated clinical outcomes at the early follow-up	• Femoral side cross-pin, metallic interference screw, bioabsorbable interference screw, and suspensory device were used in 32.3%, 27.3%, 24.8%, 15.5% of patients, respectively
				• Tibial side fixation was achieved with metallic interference screw, bioabsorbable interference screw, screw and plastic sheath, screw post and cross-pin in 38.7%, 31%, 15.7%, 12.8%, and 1.7% of patients, respectively
Muench (40)	2022	Biomechanical study	Compare knee kinematics in a cadaveric model of ACL repair using an ALD or suture anchor fixation with suture tape augmentation	• No significant differences between the three techniques

ACL, anterior cruciate ligament; ACLR, anterior cruciate ligament reconstruction; ALD, adjustable loop device, FLD, fixed loop device.