As the first adjustable-loop cortical suspensory fixation implant to use a flat SutureTape design, the new ACL TightRope II implant offers better handling characteristics and is more resistant to graft abrasion or tissue pull-through than traditional round sutures. Engineered for precise graft tensioning, the adjustable-loop mechanism allows for incremental retensioning of the graft construct after the implants have been secured on the cortex. The redesigned cortical button now incorporates a proprietary knotless fifth locking mechanism, increasing strength and resistance to cyclic displacement.