Chikih Chikih1,2,3, Sapto Adji Hardjosworo4, Taufan Favian Reyhan2, Siti Shalihah Suriadiredja2
1Sports Medicine Residency Training Program, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat, Indonesia
2Sports Medicine Physician, Ortho-sports and Wellness Center, Premier Bintaro Hospital, Tangerang Selatan, Indonesia
3Center for Sports and Exercise Studies, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta Pusat, Indonesia
4Sports Orthopedics Physician, Ortho-sports and Wellness Center, Premier Bintaro Hospital, Tangerang Selatan, Indonesia
From Biology-Limited to Mechanics-Driven Rehabilitation: A Graft-Specific Framework After Artificial Ligament Reconstruction in ACL, PCL, and Multiligament Knee Injuries
J. Anthr. Sport Phys. Educ. 2026, 10(3), 7-17 | DOI: 10.26773/jaspe.260702
Abstract
Artificial ligament reconstruction introduces a paradigm shift in postoperative rehabilitation by reducing biologic constraints and increasing reliance on mechanical load tolerance. This scoping review aimed to develop a clinically applicable, graft-specific rehabilitation framework across ACL, PCL, and multiligament knee injuries. A structured search of PubMed, Cochrane, and Google Scholar (2010–2025) was conducted following PRISMA guidelines. Eleven studies were included and appraised for methodological quality. A consistent transition from biologydriven to mechanics-driven rehabilitation was identified, enabling earlier weight bearing, muscle activation, and strength progression under controlled conditions. Based on these findings, we propose a rehabilitation velocity framework, integrating graft-specific constraints, neuromuscular readiness, and load tolerance to guide progression. Despite accelerated early-phase rehabilitation, return-to-sport decisions remain dependent on objective functional criteria rather than graft type alone. This framework provides clinicians with a structured, criteria-based approach to safely optimize recovery following artificial ligament reconstruction.
Keywords
Artificial ligament reconstruction; Graft-specific rehabilitation; Rehabilitation velocity; Multiligament knee injury; Return to sport
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