90 patients (79 at follow-up) with a unilateral anterior cruciate ligament (ACL) rupture were randomized to undergo ACL reconstruction using either the non-anatomical double-bundle hamstring autograft technique (naDBH) or the lateralized bone-patellar tendon-bone autograft (LBPTB) technique. At a minimum follow-up of 8 years, the naDBH group yielded significantly better pivot-shift test scores and incidences of degenerative joint changes, compared to the LBPTB group. In this study, there were, however, no significant differences between groups in subjective or objective International Knee Documentation Committee (IKDC) scores, side-to-side difference or anterior knee pain, and complications.