90 patients scheduled to undergo arthroscopic anterior cruciate ligament (ACL) reconstruction were randomized to either a high tension or low tension protocol for intraoperative graft tensioning. The purpose of this study was to evaluate if the high-tension cohort demonstrated improved clinical outcome measures and a lower incidence of osteoarthritis at 7-year follow-up. The results of this trial demonstrated no significant between-group differences in the incidence of osteoarthritis or clinical outcome scores. It should be noted that a group of uninjured, matched control individuals was also included in this study for analysis; for the purposes of this ACE Report, only the results of the randomized patients will be reported.