Biomechanics of Intratunnel Anterior Cruciate Ligament Graft Fixation

Interference screw fixation of bone-patellar tendon-bone grafts now is considered the standard against which all ACL graft-fixation techniques are compared, but mechanical fixation of the ACL graft in the bone tunnels is the weak link in the early postoperative period. This article discusses some of the limitations of in vitro biomechanical studies and reviews variables that influence the tensile properties of intratunnel fixation methods for bone-tendon-bone and soft tissue grafts.