40 patients requiring anterior cruciate ligament (ACL) reconstruction were randomized to undergo the procedure using either serial dilation (SD) or conventional extraction drilling (ED) of the tibial tunnel. The purpose was to compare the two techniques with respect to graft migration and knee laxity over 24 weeks, assessed using radiostereometric analysis (RSA) and a TELOS stress device. Results revealed no significant difference between groups in the migration of the graft in the femoral tunnel or knee laxity at any time during the study. The only significant difference in the migration of the graft in the tibial tunnel was at the 12-week follow-up, however the clinical impact of this finding was questionable. In addition, the SD group experienced two deep infections, whereas none were observed in the ED group.