Lesione del legamento crociato anteriore: l'intervento non è obbligatorio

Anteriore cruciate ligament (ACL) injury is the most common ligament injury of the knee joint, frequently affecting both professional and amateur athletes. Surgical options - such as ligament reconstruction, regeneration or augmentation - are widely adopted; however, conservative management remains a valid alternative in selected cases. This narrative review aims to synthesize the most recent evidence on ACL injury treatment strategies, highlighting the factors that guide clinical decision-making. Recent literature increasingly emphasizes that patient age alone should no longer be the primary determinant of treatment choice. Instead, the individual's activity level and functional demands play a more significant role in selecting the most appropriate therapeutic approach. Moreover, targeted rehabilitation programs that include muscle strengthening and proprioceptive exercises have shown to improve outcomes across both surgical and non-surgical pathways. This interventions contribute to joint stability, functional recovery, and overall patient satisfaction. Importantly, the presence of associated meniscal injuries often shifts the balance in favor of surgical interventions due to the increased risk of long term degeneration. Further research is needed to refine patient selection criteria and optimize individualized treatment protocols.