Arthroscopic ACL reconstruction surgery has become the main treatment method to address ACL injuries. The positioning and orientation of the bone tunnel in the surgical operation technique has an important impact on the function of the reconstructed ligament and the patient’s postoperative recovery. In this article, we focus on comparing the morphology and location of the femoral tunnel made by the three drilling methods in ACL reconstruction and their effects on the surgical operation and postoperative outcome. We selected a sample of 62 ACL single bundle anatomic reconstructive surgeries between May 2012 and June 2013, in which the grafts were all autologous N cord tendons, and the graft fixation methods used were: femoral end Endo-button and tibial end Intro-fix. 22 of these 62 surgeries were performed with the MTT technique, 20 with the AM technique, and 20 with the OI technique. 20 cases. The main parameters considered in this study were the intraoperative measurement of the femoral tunnel length and the postoperative 3D CT measurement of the angle between the femoral tunnel and the posterior condylar tangent in the coronal plane, the distance from the endo-femoral tunnel to the underlying cartilage surface, and the distance from the endo-femoral tunnel to the posterior wall. The final mean lengths of the femoral tunnel measured by the MTT technique, AM technique and OI technique were 42.5 mm, 34.6 mm, and 36.8 mm, respectively (P.039). The coronal angles to the posterior condylar tangent were 55.30°, 46.2°,51.2° (P>0.05), the mean distance from the femoral tunnel medial opening to the underlying cartilage surface was 4.2 mm, 3.6 mm, 3.4 mm (P>0.05), and the mean distance from the femoral tunnel medial opening to the posterior wall was 3.5 mm, 2.7 mm, 3.1 mm (P>0.05) Previous studies have shown that the AM The stability of the Lachman, anterior drawer, and axial shift tests after ACL reconstruction with the AM technique was superior to that of the TT technique; the conventional transtibial technique has difficulty locating the center of the femoral footprint and carries the risk of anterior tibial wall fracture and protrusion of the Introfix screw into the joint. The current experimental measurements showed that the AM and OI techniques had more coverage of the ACL footprint than the TT technique with the femoral tunnel inlet. Why then do we promote the MTT technique? During the actual surgical operation, the AM technique requires hyperflexion of the knee joint and is not suitable for patients with limited joint flexion such as obesity and knee stiffness; the field of view and position are mostly affected during the surgical operation; the application of the OI technique requires special instruments, which limits the promotion of this technique; the operation steps of the first two techniques are more cumbersome than those of the TT technique, and the MTT technique has been modified to meet the single-beam anatomical reconstruction. With the continuous development of surgical techniques, the modified transtibial tunnel technique (MTT) can also achieve anatomical reconstruction, and compared with the traditional tibial tunnel technique with 50% coverage of the footprint area of the anterior femoral cross stop, the MTT technique can now achieve 80% coverage of the footprint area. Summarizing our current comparison of surgical techniques, we can conclude the following: 1. There is no significant difference in the positioning of the internal port in the ACL femoral tunnel borehole between the three techniques, and the modified transtibial tunnel technique is able to cover the anatomic stop on the femoral side of the ACL and to obtain a relatively longer femoral tunnel; 2. The MTT technique requires a high tibial tunnel and in response to Introfix fixation with the risk of anterior wall fracture of the bone tract and the screw protruding too far into the joint, but it is still a more reproducible technique with some training. The three methods of ACL reconstruction: AM, OI, and MTT methods are all widely used in Prof. Wang Zimin’s sports injury treatment group. Each method has its own strengths, but they are all the same: the anatomical positioning of the bone tract, the strength of the graft and the reliable fixation. We do not believe in any one method, but we will try any one method and tell you our experience as long as it works for us. The MTT method has proven to be more concise than the other two methods, and the surgical results are equally reliable. However, the AM and OI methods are essential to master in ACL injuries, and sometimes when the MTT method cannot achieve satisfactory tunnel positioning, you can always switch to these two methods and be flexible. The battlefield is about improvisation, and if the frontal attack does not work, we can detour, and so is the surgery. A little insight to share with fellow surgeons. This paper was presented orally at the International Congress of Orthopaedic Surgery, which has just ended, and has generated a lot of interest and lively discussion among foreign scholars.