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
{"title":"前交叉韧带修复手术后重返运动的心理准备较低。","authors":"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","doi":"10.1002/ksa.12797","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>To investigate psychological readiness and psychological stress in young patients after revision anterior cruciate ligament reconstructions (ACLR).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>r</i> = −0.32; 95% confidence interval [CI] = −0.49 to −0.12; <i>p</i> = 0.002) and positive correlation was detected between IKDC and ACL-RSI scores (<i>r</i> = 0.50; 95% CI = 0.32–0.64; <i>p</i> < 0.001). There was a weak positive correlation between Pedi-FABS and ACL-RSI scores (<i>r</i> = 0.25; 95% CI = 0.05–0.43; <i>p</i> = 0.02). Revision ACLR patients had lower ACL-RSI/psychological readiness scores (43.4 vs. 58.7, <i>p</i> = 0.001) and lower Pedi-FABS scores (22 vs. 25, <i>p</i> = 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 (<i>β</i> = −17.1; 95% CI = −27.32 to −6.79; <i>p</i> = 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; <i>p</i> = 0.03). No differences were noted in Pedi-IKDC/IKDC or PROMIS-PSE scores between the cohorts.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level II.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 10","pages":"3697-3706"},"PeriodicalIF":5.0000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lower psychological readiness to return to sport after revision ACL surgery\",\"authors\":\"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\",\"doi\":\"10.1002/ksa.12797\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>To investigate psychological readiness and psychological stress in young patients after revision anterior cruciate ligament reconstructions (ACLR).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>r</i> = −0.32; 95% confidence interval [CI] = −0.49 to −0.12; <i>p</i> = 0.002) and positive correlation was detected between IKDC and ACL-RSI scores (<i>r</i> = 0.50; 95% CI = 0.32–0.64; <i>p</i> < 0.001). There was a weak positive correlation between Pedi-FABS and ACL-RSI scores (<i>r</i> = 0.25; 95% CI = 0.05–0.43; <i>p</i> = 0.02). Revision ACLR patients had lower ACL-RSI/psychological readiness scores (43.4 vs. 58.7, <i>p</i> = 0.001) and lower Pedi-FABS scores (22 vs. 25, <i>p</i> = 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 (<i>β</i> = −17.1; 95% CI = −27.32 to −6.79; <i>p</i> = 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; <i>p</i> = 0.03). No differences were noted in Pedi-IKDC/IKDC or PROMIS-PSE scores between the cohorts.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>Level II.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\"33 10\",\"pages\":\"3697-3706\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12797\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12797","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Lower psychological readiness to return to sport after revision ACL surgery
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.
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).
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