90 patients, undergoing anterior cruciate ligament (ACL) reconstruction, were randomised to receive the surgery using different graft tension procedures, to compare the clinical, functional, and osteoarthritis (OA) imaging outcomes. One group had anterior posterior (AP) laxity returned by means of low autograft tension, while the other had high autograft tension. The two groups were then compared to a control group, consisting of 60 matched healthy subjects not needing ACL reconstruction. Following assessments over a 36 month period, there were no differences in any outcomes between the two \"laxity-based\" autograft tension protocols, but significant differences existed between the tension groups and the control group. Many outcomes were not completely restored in the two tension groups, when compared to healthy knees.