This narrative review aims to synthesize current research on anterior cruciate ligament (ACL) postoperative rehabilitation, highlighting the evolution from traditional immobilization and early active motion protocols to individualized, multidisciplinary approaches. The review explores models that integrate biological, psychological, and technological factors to optimize knee function restoration, graft healing, and patient quality of life. A comprehensive literature search was conducted using the MEDLINE/PubMed and Scopus databases. Key areas of focus included graft healing, the application of mechanical loads, psychosocial influences, and the integration of advanced technologies such as biomechanical analysis and artificial intelligence. Rehabilitation models examined included standardized criteria-based protocols, functional recovery frameworks, International Classification of Functioning, Disability, and Health (ICF)-based models, and biopsychosocial approaches. The findings highlight the transition from traditional, generalized rehabilitation protocols to personalized, multidisciplinary strategies. Emerging models emphasize the need to balance standardized guidelines with individualized care, address psychosocial factors, and leverage technological innovations to refine treatment plans. These approaches show promise in addressing both physical and psychological dimensions of recovery, enhancing rehabilitation outcomes, and preventing re-injury. This review identifies three critical pillars for optimizing ACL rehabilitation: (1) calibrating rehabilitation to biological graft healing phases to balance tissue protection and mechanical stimulation; (2) integrating psychological readiness assessment using validated instruments to address kinesiophobia and self-efficacy; and (3) leveraging technological innovations such as motion capture and artificial intelligence for objective monitoring and individualized planning. Significant knowledge gaps remain regarding optimal loading parameters across graft types, standardized psychological intervention protocols, and long-term outcomes beyond 2 years. Future research should prioritize multidisciplinary integration, cost-effectiveness of emerging technologies, and sustained functional recovery to advance personalized, evidence-based rehabilitation strategies.
Hao et al. (Thu,) studied this question.