Editorial Commentary: Technical Advances in Fixation for Arthroscopic Anterior Cruciate Ligament Reconstruction Won't Take the Place of Good Technique…Or a Strong Arm!

Advances in fixation technology have improved the time-zero stability of grafts used for anterior cruciate ligament reconstruction, but the clinical impact of this is unclear. Adjustable-loop-length devices are the latest iteration of cortical fixation and offer retensioning of the graft after tibial fixation. This capability is absent in traditional closed-looped devices and interference screws, but there are concerns with the adjustable mechanism maintaining tension with cyclic loading. Although this advance may represent an additional tool for fine-tuning graft tension, it does not replace good technique in the use of anterior cruciate ligament fixation devices.