Table 6. The advantages and disadvantages of various anterior cruciate ligament reconstruction graft fixation methods.

Fixation method	Advantages	Disadvantages
Compression	• ↓ Graft-tunnel micromotion• ↓ Tunnel widening • ↓ Graft creep	• Risk of screw-tunnel divergence • Graft damage • Cancellous fixation • Graft slippage
Suspensory	• Minimally invasive • ↑ Tension between graft/bone interface • Cortical fixation • Similar biomechanics to compression	• ↑ Graft-tunnel motion • “Windshield wiper phenomenon” • Tunnel widening
Suture anchor	• Maintenance of tension	• Anchor pull-out
Post/staple	• Useful in open physes• Useful in graft-tunnel mismatch • Stable, inflexible fixation	• Hardware irritation • More invasive

↓, decreased; ↑, increased.