The graft is introduced into the parapatellar incision and pushed carefully into the tibial socket. Occasionally a hypertrophic medial plica prevents the passage and has therefore to be removed. Sometimes slight extension of the knee-joint facilitates the passage of the graft beneath the patella. Under direct endoscopic vision a mallet is tapped onto the guide wire until the tibial end is fully seated inside the tibial socket. The guide wire is removed using a vise-grip.