Noonan BC, et al. - Tripled smaller-diameter (8 mm) and quadrupled (9 mm) bovine tendon grafts with and without suture tape reinforcement (n = 8 in each group) were tested utilizing femoral suspensory and tibial interference screw fixation in a biomechanical in vitro research, in order to contrast the impact of independent suture tape reinforcement on the dynamic elongation and stiffness behavior as well as ultimate force of tripled smaller-diameter and quadrupled soft-tissue grafts for anterior cruciate ligament reconstruction (ACLR) with tibial screw fixation. In comparison with quadrupled constructs at higher loads, tripled constructs exhibited a notably worse structural performance. It was found that independent reinforcement of soft-tissue grafts with suture tape reinforced the performance particularly of tripled smaller-diameter grafts for ACLR with tibial screw fixation by notably enhancing dynamic elongation at increased stiffness and ultimate force. Moreover, quadrupled reinforced grafts exhibited no over-constraining and structurally behaved likewise to tripled grafts with reinforcement.