Wang LJ, et al. - This review explored the incidence of anterior cruciate ligament (ACL) injury that progresses to post-traumatic osteoarthritis (PTOA), evaluate the role of ACL reconstruction in preventing PTOA, imply possible mechanisms thought to be responsible for PTOA, evaluate current diagnostic methods for detecting early osteoarthritis (OA), and present potential interventions to combat PTOA. While much work has been performed, researchers also distinguish important directions for future study. Among individuals with a history of ACL injury, the incidence of PTOA remains high due to the complexity of ACL injury progression to PTOA, the lack of sensitive and easily accessible diagnostic procedure to diagnose OA development, and the limitations of current treatments. Many individuals undergo surgical reconstruction of ACL to restore joint stability and prevent excessive loading after ACL injury. It was demonstrated that a complete understanding of mechanisms to stratify the patients into different subgroups on the basis of risk factors is critical. And the enhancement of standardized and quantitative evaluation procedures is required to guide intervention. In the future, treatments focused toward different pathogenic pathways may be crucial to the management of PTOA.