Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 10 1 2024 04 01 25 7 Prashant Modi Associate Professor, Department of Orthopedics, SMS Medical College, Jaipur, Rajasthan, India Aditya Rathore Senior Resident, Department of Orthopedics, SMS Medical College, Jaipur, Rajasthan, India Shubham Agarwal MS orthopaedics 2023 04 16 2024 03 13 Background: The anterior cruciate ligament (ACL) is a vital knee joint stabilizer with rising injury rates. Anatomic ACL reconstruction aims to restore the ACL to its original dimensions, collagen orientation, and insertion sites, but complete restoration may not be possible. Suture augmentation (SA) involves the use of autologous hamstring tendons with a braided ultra-highmolecular weight polyester or polyethylene suture or suture tape to act as a secondary stabilizer until complete integration. This study aimed to compare the outcomes of ACL reconstruction using hamstring grafts with and without suture augmentation. Methods: This trial was conducted at a tertiary-level health care center, with 50 patients divided randomly into two groups: 25 patients for standard ACL reconstruction (Group A) and 25 patients for ACL reconstruction with suture augmentation (Group B). Participants provided informed consent. We collected baseline clinical characteristics range of motion (ROM), pain (numeric pain rating scale, NPRS), and functional outcomes (Lysholm and International Knee Documentation Committee, IKDC scores). Results: The mean age was 25.5 years, with 96% male and 4% female participants. We found a statistically significant improvement in both groups in ROM, NPRS scores, and functional outcomes at 1 and 6 months. There was no significant difference in both groups regarding the IKDC score. Lysholm’s score showed a remarkable improvement in both groups. Conclusion: The study concluded that suture augmentation could be an effective technique for ACL reconstruction, with comparable outcomes to standard ACL reconstruction. https://jost.tums.ac.ir/index.php/jost/article/view/488 https://jost.tums.ac.ir/index.php/jost/article/download/488/355