Synthetic material as a substitute of ruptured anterior cruciate ligament (ACL) has been attempted in the past with early success but poor long-term outcomes, hence discontinued. In the last decade, there has been a resurgence of synthetic augmentation to protect the repair in ACL repairs and to protect the graft in ACL reconstructions. However, the biological and mechanical complications associated with intra-articular use of synthetic material still remain a challenge against their routine use in ACL surgery.