Lower psychological readiness to return to sport after revision ACL surgery

IF 5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-07-18 DOI:10.1002/ksa.12797

Magdalena Tarchala, Matthew D. Milewski, Emma C. Gossman, Ryan P. Coene, Danielle L. Cook, Mininder S. Kocher, Dennis E. Kramer, Lyle J. Micheli, Yi-Meng Yen, Melissa A. Christino

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引用次数: 0

Abstract

Purpose

To investigate psychological readiness and psychological stress in young patients after revision anterior cruciate ligament reconstructions (ACLR).

Methods

Revision ACLR patients were evaluated 6-months post-operatively with patient reported outcomes (PROs): Anterior Cruciate Ligament Return to Sport After Injury Scale (ACL-RSI), PROMIS-Psychological Stress Experience (PROMIS-PSE), International Knee Documentation Committee (IKDC/Pedi-IKDC) and Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Patient reported outcomes (PROs) of revision ACLR patients were compared to a cohort of primary ACLR patients. Propensity score matching between primary and revision cohorts (2:1) was performed for age, sex, and graft type.

Results

Matching resulted in 90 ACLR patients (60 primary and 30 revision). The revision cohort's mean age was 19.0 (SD ± 3.46) and 63% female. A negative correlation was detected between IKDC and PROMIS-PSE (r = −0.32; 95% confidence interval [CI] = −0.49 to −0.12; p = 0.002) and positive correlation was detected between IKDC and ACL-RSI scores (r = 0.50; 95% CI = 0.32–0.64; p < 0.001). There was a weak positive correlation between Pedi-FABS and ACL-RSI scores (r = 0.25; 95% CI = 0.05–0.43; p = 0.02). Revision ACLR patients had lower ACL-RSI/psychological readiness scores (43.4 vs. 58.7, p = 0.001) and lower Pedi-FABS scores (22 vs. 25, p = 0.02), compared to primary ACLR patients. Regression analysis showed revision patients had a 17-point decrease in ACL-RSI scores compared to primary patients (β = −17.1; 95% CI = −27.32 to −6.79; p = 0.001), controlling for age at primary surgery, meniscus repair, and propensity score. Revision patients had a 17% increase in the time to return to sports clearance compared to primary ACLR patients (95% CI = 1.02–1.34; p = 0.03). No differences were noted in Pedi-IKDC/IKDC or PROMIS-PSE scores between the cohorts.

Conclusion

Patients 6-months post revision ACLR had lower psychological readiness, inferior knee outcomes, and delayed return to sport clearance. Greater attention to the psychological aspects of recovery in revision ACLR patients is important to optimise post-operative care and outcomes.

Level of Evidence

Level II.

Abstract Image

查看原文本刊更多论文

前交叉韧带修复手术后重返运动的心理准备较低。

目的：探讨青年前交叉韧带重建术（ACLR）翻修后患者的心理准备状况和心理压力。方法：对改良ACLR患者进行术后6个月的评估，患者报告的结果（PROs）：前交叉韧带损伤后恢复运动量表（ACL-RSI），允诺-心理应激体验（允诺- pse），国际膝关节文献委员会（IKDC/ pedii -IKDC）和特殊外科医院儿童功能活动简要量表（HSS pedii - fabs）。将改良ACLR患者的患者报告结果（PROs）与原发性ACLR患者队列进行比较。根据年龄、性别和移植物类型对初级队列和修订队列进行倾向评分匹配（2:1）。结果：匹配90例ACLR患者（60例原发，30例翻修）。修订队列的平均年龄为19.0 (SD±3.46)，63%为女性。IKDC与promise - pse呈负相关(r = -0.32；95%置信区间[CI] = -0.49 ~ -0.12；p = 0.002)， IKDC与ACL-RSI评分呈正相关(r = 0.50；95% ci = 0.32-0.64；结论：ACLR翻修后6个月的患者心理准备程度较低，膝关节预后较差，运动恢复延迟。更多地关注改良ACLR患者恢复的心理方面对于优化术后护理和结果是重要的。证据等级：二级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).