189 anterior cruciate ligament (ACL) reconstructions were performed with either a double-bundle hamstring approach or rectangular tunnel technique with bone-patellar tendon-bone graft. The purpose was to determine if there was a difference in outcome between the two reconstruction techniques. Patients underwent clinical evaluation for 2 years postoperatively. Results at final follow-up indicated that knee laxity, clinical outcome, and muscle strength evaluations were similar between groups, although those who had undergone the rectangular tunnel ACL reconstruction with the patellar tendon did experience lower quadriceps strength within the first 9 postoperative months.