49 skeletally mature patients scheduled for an arthroscopically-assisted single-bundle ACL reconstruction were randomized to have the procedure performed with a remnant preservation or remnant debridement technique. Outcomes of interest included the incidence and timing of both ACL re-tear in the ipsilateral knee or tear in the contralateral knee, requirement of at least 1 additional surgery in the ipsilateral and contralateral knees, proportion of patients returning to unrestricted activity, and knee function (measured on a numerical rating scale). Follow up was performed 10 years post-operation. The results of the study revealed a significantly higher number of patients who required an additional surgery in the ipsilateral knee in the remnant preservation group compared to the remnant debridement group. There were no significant differences between groups in the rate of re-tear, rate of tear in the contralateral knee, requirement of additional surgery in the contralateral knee, proportion of patients returning to unrestricted activity, or knee function.