Abstract:[Objective]To compare and analyze the short- and medium-term clinical efficacy of conventional anterior cruciate ligament reconstruction and arthroscopic anchor nailing for stump preservation.[Methods]A total of 51 patients with anterior cruciate ligament reconstruction from March 2019 to March 2021 were retrospectively analyzed, all of whom had their anterior cruciate ligaments reconstructed with autologous hamstring tendons. In the conventional group of 26 cases, only the ligament was reconstructed; in the residual preservation group of 25 cases, on the basis of the reconstructed ligament, the torn anterior cruciate ligament stump at the femoral end was fixed tightly around the femoral tract by applying a wire anchor nail. The perioperative conditions and functional scores before and after surgery were compared between the two groups.[Results]All 51 patients underwent successful surgery without vascular or nerve injury. The surgery time was longer in the disability-preserving group, but the time to walk on the ground was earlier, and the difference was statistically significant (P < 0.01); both groups recovered knee stability after surgery, and the difference was not statistically significant (P > 0.05); on the functional score, the Lysholm and IKDC2000 scores were higher in the disability-preserving group at the three-month follow-up, and the difference was statistically significant (P < 0.05); knee passive angle regeneration test, the difference between the two groups at 3 months postoperatively was statistically significant (P < 0.01); in the case of bone marrow tract enlargement, the disability-preserving group was less than the conventional group at 3 months postoperatively, and the difference was statistically significant (P < 0.05); in the K-L joint degeneration rating, the difference between the two groups was not statistically significant (P > 0.05).[Conclusion]Both conventional reconstruction and combined anchor nailing for disability preservation can restore joint stability, and in the short term anchor nailing for disability preservation restores knee function and proprioception better, but there is no significant difference between the two procedures in the medium and long term.