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Suture augmentation, applied to either ACL reconstruction (ACLR) or primary repair, introduces a \u201csafety belt\u201d synergistically sharing loads acting on the graft or repair. Several biomechanical studies using different autologous grafts for ACLR, as well as studies on ACL repair, have shown that suture augmentation enhances strength and prevents elongation of the graft or ligament. Suture augmentation can protect the graft\u2010brace integrity under loads of 350 N, and reduces cyclic displacement by up to 31% compared with conventional ACLR using bone\u2013patellar tendon\u2013bone allograft. Perhaps, as above, the greatest advantage of suture augmentation is allowing early rehabilitation. Assuming successful ligamentization of the graft, the graft itself should stabilize the knee joint, thereby diminishing the long\u2010term benefit of suture augmentation. In practice, we use suture augmentation to support immediate postoperative mobilization and weight bearing, enabling safe and early rehabilitation while minimizing the risk of failure. Regarding the oft\u2010mentioned risk of overconstraint, this is not supported by biomechanical studies or clinical experience. The recent introduction of collagen co\u2010braid sutures for suture augmentation offers 2 distinct advantages: first, potentially improved biocompatibility, and second, gradual biological integration allowing suture degradation over time.<\/jats:p>","DOI":"10.1016\/j.arthro.2024.10.022","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T05:31:55Z","timestamp":1730093515000},"page":"1942-1946","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["<i>Editorial Commentary:<\/i>\n                    Anterior Cruciate Ligament Reconstruction or Repair With Suture Augmentation Allows Early Rehabilitation: Collagen Co\u2010braid Sutures May Improve Biological Integration"],"prefix":"10.1002","volume":"41","author":[{"given":"Maximilian Michael","family":"Mueller","sequence":"first","affiliation":[{"name":"Weill Cornell Medical College Cornell 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