Introduction. The increase in the sport activities and
the traffic accidentability has raised an increase of the injuries
of the knee and more precisely of the anterior cruciate ligament.
The residual instability, the degenerative changes in the
joint and the secondary lesions have been invocated as reasons
to justify a surgical approach. But, the incomplete consecution
of the aims of this treatment has provoked that the conservative
option is still in use. Aims: To analyze the scientific
evidence in the bibliography for the treatment of the lesions of
the knee ACL, to establish if the aims of the treatment are observed
in the conservative and surgical options and to conclude
with a recommended guide to face these injuries. Material
and methods: It is analized the scientific evidence in the reviewed
literature in this topic. It is projected a metanalysis with
the integrated bibliography for the selected papers. This should
assure the criteria of being comparative between the conservative
and surgical treatment and should be prospective and
randomized, with a minimum follow-up of seven years and taking
into account an analysis of the results with objective criteria,
as well as an evaluation of the subjective satisfaction of
the patient. Results: No papers have been found that properly
fit for the exigencies of the design. Two sequential papers have
been selected with a shorter follow-up and with a comparison
between three different treatments, none of them being a complete
conservative treatment. The proposed surgical technique,
the suture of the disrupted ACL, is not any more among the
preferred by the surgeons. Conclusions: The option with less
residual instability is the direct suture with a peripheral plastia.
But, they do not provide an absolute stable knee. The reincorporations
to the sport activities, as well as the secondary structural
lesions are independent to the treatment. Because of the
lack of complementation of the exigencies of the evaluation
and the lack of adequacy of the proposed surgical techniques,
it is not possible to recommend a practical guide.

Introduction. The increase in the sport activities and
the traffic accidentability has raised an increase of the injuries
of the knee and more precisely of the anterior cruciate ligament.
The residual instability, the degenerative changes in the
joint and the secondary lesions have been invocated as reasons
to justify a surgical approach. But, the incomplete consecution
of the aims of this treatment has provoked that the conservative
option is still in use. Aims: To analyze the scientific
evidence in the bibliography for the treatment of the lesions of
the knee ACL, to establish if the aims of the treatment are observed
in the conservative and surgical options and to conclude
with a recommended guide to face these injuries. Material
and methods: It is analized the scientific evidence in the reviewed
literature in this topic. It is projected a metanalysis with
the integrated bibliography for the selected papers. This should
assure the criteria of being comparative between the conservative
and surgical treatment and should be prospective and
randomized, with a minimum follow-up of seven years and taking
into account an analysis of the results with objective criteria,
as well as an evaluation of the subjective satisfaction of
the patient. Results: No papers have been found that properly
fit for the exigencies of the design. Two sequential papers have
been selected with a shorter follow-up and with a comparison
between three different treatments, none of them being a complete
conservative treatment. The proposed surgical technique,
the suture of the disrupted ACL, is not any more among the
preferred by the surgeons. Conclusions: The option with less
residual instability is the direct suture with a peripheral plastia.
But, they do not provide an absolute stable knee. The reincorporations
to the sport activities, as well as the secondary structural
lesions are independent to the treatment. Because of the
lack of complementation of the exigencies of the evaluation
and the lack of adequacy of the proposed surgical techniques,
it is not possible to recommend a practical guide.