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Twenty-eight patients who had reconstructions of the anterior cruciate ligament with a ligament augmentation device in the semitendinosus and gracilis tendons were compared with 32 patients who had reconstructions with semitendinosus and gracilis tendons alone. Preoperatively, there was no significant difference between the 2 groups with respect to age, sex, Tegner activity level, and time from injury to operation. Mean postoperative followup was 31.4 months for the augmentation group and 32.3 months for the nonaugmentation group. At postoperative evaluation, there was no difference in the 2 groups with respect to Lysholm knee scores, return to activity as measured by Tegner levels, KT-1000 arthrometer laxity testing, presence of pivot shift or Lachman sign, range of motion, and the patient's subjective overall rating of the surgery. Twenty-six of the 28 patients (93%) with augmentation rated their results as either "good" or "excellent" compared with 30 of the 32 patients (94%) with no ligament augmentation who rated their results as good or excellent. Four patients with the ligament augmentation devices needed reoperation for recurrent effusions and pain. No patients in the nonaugmentation group had recurrent effusions.