Editorial Commentary: Time-Zero Biomechanical Studies Show Suture Augmentation of a Soft-Tissue Graft Improves Its Properties, But They Need to Be Interpreted With Caution.

There is emerging evidence in biomechanical studies that suture augmentation of a soft-tissue graft can improve its elongation, stiffness, and load to failure. However, all biomechanical studies have the intrinsic drawback of not considering loosening, accommodation, and mainly, healing. In the past, many very strong and stiff synthetic grafts produced poor results for anterior cruciate ligament reconstruction, and synthetic material inside the joint was abandoned for awhile. Recent studies have shown that it is possible to use synthetic material to augment the graft instead of being the graft itself. But the question we need to ask ourselves is: Does it really work in the clinical scenario? Undoubtedly, there is still a way to go to incorporate suture augmentation into soft-tissue grafts in knee reconstruction, and it is mandatory to start high-level clinical studies to prove its real benefit to ligament reconstruction results.