40 patients undergoing single-bundle anterior cruciate ligament (ACL) reconstruction surgery were randomized to undergo the procedure with either a modified transtibial or anteromedial portal technique. The purpose of the trial was to assess whether clinical outcomes and femoral tunnel characteristics were different between the groups. Both groups demonstrated significant improvement in clinical outcome measures, without significant between-group differences for any measure. Positioning of the femoral tunnel opening relative to Blumensaat's line did not significantly differ between groups, nor did sagittal angulation of the femoral tunnel. Differences between groups were noted in coronal angulation of the femoral tunnel, was well as the size of the femoral tunnel opening.