One hundred and fifty patients undergoing reconstructive surgery for an anterior cruciate ligament (ACL) injury were randomized to a procedure with either a full tibial bone tunnel or an all-inside tibial socket. The purpose of the study was to compare the clinical and functional outcome of these techniques, along with their effect on tunnel widening. The results indicated primarily no significant difference in outcome between the two tunnel techniques, although a greater reduction in postoperative pain was observed in those treated with an all-inside tibial socket, observed as early as postoperative day 1 and at 24 months after surgery.