: The normal kinematics of the knee are disrupted by anterior cruciate ligament (ACL) injuries, which also increase the risk of secondary injuries such meniscal tears and osteoarthritis of the knee. The most frequent and well-liked procedure to regain knee stability is surgery. ACL reconstruction involves the use of numerous graft types and graft anchoring techniques. With the majority of these graft fixation techniques, arthroscopic ACL restoration surgery is quite successful in achieving knee stability.(1)(2) The development of pre- and postoperative rehabilitation programmes, as well as the various types of dependable and potent graft fixation implants established in recent years, are two elements that boost surgical success.(3) (4) The most popular implants used in ACL surgery are the ACL Tightrope and Transfix from Arthrex Inc., Naples, FL, USA. While Transfix allows the suspension of the graft from the femur by being coiled around the transfix screw that is inserted through the lateral side of the lateral femoral condyle toward the condyle medulla, Tightrope Implant allows the suspension of the graft from the lateral femoral condyle cortex using a button implant. Hence, transfix and tightrope are two different techniques, and as a result, various problems may be experienced. For tightrope, the button may not flip, become blocked inside the femoral tunnel, or flip in soft tissue. For transfix, problems like nitinol wire breakage, screw missing the target, and iliotibial band discomfort may occur. Therefore, further information regarding the superiority of these fixation methods compared with each other is required. This study tries to compare the clinical outcomes of femoral fixations made using tightrope and transfix for use in arthroscopic ACL restoration