Table 1.

Advantages and Disadvantages of the ACL Adjustable-Loop Fixation Technique

Advantages

The expanding flaps of the GraftBolt sheath within the tibial tunnel and interference screw provides a strong tibial graft fixation.

Alternating between both of the white tensioning suture strands retensions the ACL graft and ensures a taut construct, with the graft fully seated within the femoral tunnel.

The ability to retension the graft after definitive tibial fixation may eliminate the need for a posterior drawer force on the knee during tibial sheath and interference screw insertion.

There is a low risk of wound healing complications given the small incisions required for this ACL reconstruction technique.

Disadvantages

Graft tension is lost after interference screw fixation by advancing the graft further into the tibial tunnel. This occurs even with strong countertraction on the tibial tails of the graft.

ACL, anterior cruciate ligament.