Techniques and reconstruction systems for ligament repair and fixation. A bone tendon graft is prepared by folding the bone block over a suspensory fixation device (for example, a knotless suture construct such as a knotless, adjustable, self-cinching suture loop/button construct, a suture, crosspin, or screw, etc.). A flexible strand is then used to suture the bone plug to the tendon so that the overall graft is shortened significantly and the suspensory fixation device is securely attached. The technique does not require passage of the suspensory fixation device through the bone block which makes the graft passage easier since the graft is pulled from the tip. The technique also allows shortening of the overall graft.
