Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 2 2009 04 15 143 148 EN Mohammad Hasan Kaseb Department of Orthopedic Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Amir Reza Sadeghifar Department of Orthopedic Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mohammad Javad Mortazavi Department of Orthopedic Surgery and Sports Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months). Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86) preoperatively and 91.88(73-100) at the latest follow up (P < 0.005). No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft. https://acta.tums.ac.ir/index.php/acta/article/view/3562 https://acta.tums.ac.ir/index.php/acta/article/download/3562/3538