90 patients undergoing an anterior cruciate ligament reconstruction (ACLR) with either a bone-patellar tendon-bone (BPTB) or hamstring (HS) autograft were randomized to receive the graft with high tension (AP laxity of knee over-constrained by 2mm) or low tension (normal tension). Outcomes of interest included tibial tunnel diameter and patient reported outcomes (KOOS; SF-12 v2 health questionnaire). Follow up was conducted at 1, 3 and 7 years. The results from this study found a significant increase in tibial tunnel diameter in the HS group over 7 years in both tension groups. In contrast, the BPTB group did not display any significant differences in tibial tunnel diameter over 7 years in both tension groups. There was no difference in patient reported outcomes between the two graft types, or two graft intensities.