Objective To explore the clinical effect of “ideal point” isotonic reconstruction of the femoral side of anterior cruciate ligament reconstruction (ACLR)，in order to provide a basis for the clinical operation of ACLR.Methods This study was a retrospective case-control study.The 98 eligible patients with anterior cruciate ligament injury who were admitted to the Department of Orthopaedics of Fuyanshan Hospital of The Affiliated Hospital of Weifang Medical University from January 2020 to October 2022 were Studied.According to the different femoral lateral positioning，the patients were divided into two groups.There were 42 patients in the control group with 22 males and 20 females.The patients aged 19~31 years，with an average age of (25.34±5.93) years.The femoral lateral positioning plan in the over the top position was chosen.The observation group consisted of 56 patients，including 26 males and 30 females.The age of patients was 20 to 32 years，with an average age of (26.14±6.05) years.The Isometric，Direct inserted，Eccentrically located and Anatomical perfect with Low tension (I.D.E.A.L) site for femoral lateral localization was chosen.The general baseline data of the two groups of patients were collected，and the surgery related data were collected.The knee joint pain of the patients was evaluated using the visual analogue scale (VAS) and the numerical rating scale (NRS)，and the knee joint function of the affected limb was evaluated using the international knee documentation committee (IKDC) scoring system and the Lyshlom scoring system，The postoperative complications were counted.Results There was no statistically significant difference in the general data of the two groups，including age，sex，height，weight，BMI，cause of injury，location of broken limb and ligament (P＞0.05).The VAS score and NRS score of the patients in the observation group were significantly lower than those in the control group in the comparison of knee joint pain scores 1 day and 1 month after operation (P＜0.05).In the comparison of knee joint function one day after operation and one month after operation，the IKDC score and Lyshlom score of patients in the observation group were significantly higher than those in the control group (P＜0.05).The incidence of late complications in the observation group was significantly lower than that in the control group (P＜0.05).Conclusion The ACLR operation with I.D.E.A.L positioning on the femoral side can achieve more early postoperative results，reduce postoperative pain and the incidence of late complications.