The TightRope ACL has revolutionized cortical fixation by enabling intraoperative adjustment, while providing a strong and rigid set thanks to the patented four-point closure system. The ACL TightRope RT provides a new option that allows the surgeon to adjust the implant by pulling the adjustment cords in the same direction as the graft advances. This innovation eliminates the need to recover the adjustment cords from the joint and allows the surgeon to pull in line with the advancement of the graft.