Secure graft fixation for anterior cruciate ligament reconstruction is an important goal. Optimally, graft fixation allows for an aggressive postoperative rehabilitation program with the goals of immediate full range of motion, full weight bearing, and an early return to athletic activity. Current anterior cruciate ligament reconstruction techniques advance soft tissue grafts with or without bone plugs into the joint to replace the damaged ligament. Segments of these grafts are fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. The graft fixation should be secure, allow normal tendon healing, and provide the graft construct with biomechanical properties, which approach that of the native ligament. Several different fixation devices are available for anterior cruciate ligament construction.