how many tightrope buttons were used in the note provided : The patient was identified in the preoperative holding area, and the operative extremity was marked.  The patient underwent a nerve block by Anesthesia, brought back to the operating room, and underwent general anesthesia.  Examination revealed a positive NAME_1 and positive pivot shift.  On the left side, the left leg was then prepped and draped in the usual standard fashion.  A time-out was performed.  IV antibiotics was given.  On the back table, GraftLink allograft was prepared with the TightRope button on the femoral sided and adjustable button suture on the tibial side.  It was tensioned.  It was 9 mm on the femoral side and 9.5 mm on the tibial side.  We placed an InternalBrace.  There was an InternalBrace, which was a FiberTape through the TightRope button.  It was 6-9 mm in length.  While this was going on, the Esmarch was used to exsanguinate the limb.  The tourniquet was inflated to 300 mmHg.  The standard medial and lateral parapatellar portals were created.  Examination revealed a tear of the ACL off the femoral insertion.  Examination revealed a small radial tear of the medial meniscus in the body.  A biter and shaver was used to trim the meniscus back to a stable rim.  The articular cartilage was intact.  Examination of the lateral compartment revealed intact lateral meniscus and intact articular cartilage.  The scope was placed in the patellofemoral compartment.  There were some grade 2 changes on the undersurface of the patella.  Attention was then taken back to the notch.  The ACL stump was debrided.  Then, using the medial portal guide and a flexible guidepin, I placed the flexible guidepin at the anatomic insertion of the ACL creating a 9 x 25 mm frontal socket.  I used 4.5-mm reamer to create an interosseous tunnel.  I then placed two ends of the FiberTape through the guidepin, pulled it out so I had the looped end sitting at the medial portal.  The sutures were tensioned, so they were out of our way.  Then, using Arthrex tibial guide and FlipCutter, I created a 9.5- x 30-mm tibial socket.  I got rid of all bony and soft tissue debris.  We passed our FiberTape through the guide, so I had the looped end sitting at the medial portal.  I then placed the sutures for the TightRope button to the FiberTape, pulled the sutures through the tunnel out proximally.  I advanced the button and flipped it on the lateral femoral cortex.  I pulled all the sutures and seated the graft about 20-mm within the femoral socket.  I then placed the sutures fr