Thirty- seven patients were enrolled in a single-blind prospective randomized clinical trial comparing the use of the Endopearl in femoral fixation in otherwise similar anterior cruciate ligament (ACL) reconstructions. Evaluation pre-operatively, three months, six months and eighteen months post-operatively suggested significant difference in the side to side KT-1000 values suggesting improved graft fixation with the EndoPearl by eighteen months post surgery with no differences in the Mohtadi ACL QOL questionnaire. Thus, when bioabsorbable interference screws are used for ACL reconstruction, the use of the EndoPearl improves anterior-posterior stability up to eighteen months post-operatively. The EndoPearl is an adjunct to bioabsorbable interference screw fixation in the femoral tunnel in ACL reconstruction. The purpose of the study was to assess the clinical effectiveness of the EndoPearl using the KT-1000 Knee Arthrometer and the Mohtadi ACL Quality of Life (ACL-QOL) Questionnaire. The application of the EndoPearl in hamstring ACL reconstruction has no significant benefit when compared to conventional treatment in KT-1000 and ACL-QOL Questionnaire outcomes. Prospective Single-blind Randomized Clinical Trial. ACL reconstruction with autogenous semitendino-sus and gracilis tendons was performed on thirty-seven patients. Pre-operatively, three months, six months and a eighteen months post-operatively, patients’ knees were evaluated using the KT-1000 Knee Arthrometer and the ACL-QOL questionnaire. Statistically significant differences were achieved in terms of KT-1000 side-to-side differences between the study group and the control group at six months and eighteen months post-operatively; the mean-side-to-side differences are significantly less in the study group when compared to the control group. Statistically significant differences could not be detected when comparing the ACL-QOL questionnaire between the two groups. The application of the EndoPearl in conjunction with a bioscrew in the femoral tunnel in autogenous ACL reconstruction using semitendinosus and gracilis tendon grafts provides a significantly decreased laxity up to eighteen months post-operatively in terms of KT-1000 side-to-side differences. In an accelerated post-operative rehabilitation program, patients and doctors have increased confidence in terms of graft stability with the application of the Endo-Pearl in hamstring ACL reconstruction. Please contact author for pictures and/or diagrams.