Editorial Commentary: Independent Suture Tape Reinforcement Could Be a Part of the Holy Anterior Cruciate Ligament Grail Puzzle?

The quest for improvement of anterior cruciate ligament (ACL) reconstruction results is a continuous struggle as we endeavor different technique adjustments that could form a missing piece of the holy ACL grail puzzle. Independent suture tape reinforcement (ISTR) is a small addition to the familiar ACL reconstruction technique with the potential to improve reconstruction results. Biomechanical studies show a decreased graft elongation and increased ultimate load to failure with ISTR. Clinical studies are scarce. In contrast to the ACL augmentation results in the 1980s, 2 retrospective comparative studies do not report negative results, which would support further research. Larger clinical trials will have to prove whether this small addition to ACL reconstruction will have a positive impact on ACL reconstruction results. For now, it is promising to note that no "red flags" have been described for ACL reconstruction with ISTR.