Table 1.

Advantages and Disadvantages of Crossing Internal Suture Augmentation Technique

Advantages

Protection of the ACL graft from excessive accidental acute loads during the early postoperative period, thus preventing early failure due to implant failure

Protection of the ACL graft from excessive chronic loads that may result in stretching and relaxation of the graft

Possibility of more secure rehabilitation at an earlier phase, thus potentially being beneficial in contact and professional athletes and patients with a high BMI, as well as patients with osteoporosis

Expected special value when using allograft and when used in patients with a smaller graft diameter because of thin tendons

Disadvantages

Potential stress shielding if the tension of the FiberTape is higher than the tension of the graft—however, this point needs further research

Higher costs than the standard technique (cost of the additional FiberTape and the SwiveLock anchor)

Potential for over-tightening the joint and limitation of extension

ACL, anterior cruciate ligament; BMI, body mass index.