25 patients with fresh anterior cruciate ligament ruptures were followed up 36 months after primary suture. Every fourth knee was unstable and in 20/25 of the patients the level of activity was reduced. The study indicates that a county hospital can obtain results comparable with those of university clinics when performing primary suture. The results may be improved by means of augmentation techniques in ACL injuries in the young, active population. It is concluded that also county hospitals equipped with orthopedic specialists should be able to carry out augmentation procedures in ACL tears.