Objective To review the research progress and application prospects of brain-computer interface (BCI) in orthopedic rehabilitation and motor function restoration. Methods Through literature analysis, the neurophysiological mechanisms of BCI in improving central motor drive deficits, technical paradigms, and clinical evidence in quadriceps inhibition after anterior cruciate ligament reconstruction and other orthopedic conditions were summarized, and the challenges in clinical translation were discussed. Results BCI decodes movement-related neural signals and establishes closed-loop feedback between central and peripheral systems, which can enhance corticospinal tract excitability, induce neuroplasticity, and alleviate postoperative muscle inhibition and dysfunction caused by insufficient central motor drive. Available evidence indicates that motor imagery-based BCI training can improve quadriceps voluntary activation rate and reduce muscle strength loss after surgery, showing potential intervention value in other orthopedic conditions. Conclusion BCI holds promise as an important adjunct to conventional orthopedic rehabilitation, particularly for patients with central motor drive deficits. However, its clinical translation still faces challenges including insufficient mechanistic evidence, high patient heterogeneity, and lack of standardized training protocols, which represent key directions for future research.
