BTB Adjustable Loop implant is a device used to fix bone-tendon ACL grafts, designed to be simple and strong. It features an adjustable locking system with a four-point locking mechanism that can be adjusted for precise adjustments. The implant can be placed through a small drill hole in the cortical bone block, minimizing invasion. Button provides reliable cortical fixation, while the adjustable loop allows for graft adjustability to match the graft tunnel. Conventional arthroscopic techniques can be used to create anatomically placed sockets. The BTB Adjustable Loop implant provides 360° of graft contact to the socket, ensuring secure fixation. Additionally, it eliminates the need for knots or cinching, making it an ideal solution for fixing BTB grafts in hard-to-reach femoral sockets where traditional interference screws may be impractical.