The ACL Adjustable Loop has revolutionized cortical fixation by allowing intraoperative adjustability of cortical fixation while providing a stiff, strong construct due to the proprietary four-point locking system:1,2 The Adjustable Loop provides another option which allows the surgeon to adjust the implant by pulling tensioning strands in the same direction of graft advancement. advancement. This innovation eliminates the need to retrieve shortening strands from the joint and allows the surgeon to pull in line with graft advancement.