Abstract | BACKGROUND: Psychological responses after anterior cruciate ligament ( ACL) injury and ACL reconstruction (ACLR) have been identified as predictors of return to sport but have not been investigated in relation to further injury. PURPOSE/HYPOTHESIS: To determine whether psychological readiness to return to sport is associated with second ACL injury. It was hypothesized a priori that at both preoperative and 12-month postoperative time points, patients who sustained a second ACL injury would have lower psychological readiness than patients who did not have a second injury. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Patients who had a primary ACLR procedure between June 2014 and June 2016 completed the ACL-Return to Sport after Injury (ACL-RSI) (short version) scale before their ACLR and repeated the scale at 12 months after surgery to assess psychological readiness to return to sport. Patients were followed for a minimum of 2 years (range, 2-4 years) after surgery to determine further injury. The primary outcome was the relationship between ACL-RSI scores and the incidence of second ACL injury. RESULTS: In 329 patients who returned to sport after ACLR, 52 (16%) sustained a second ACL injury. No difference in psychological readiness was observed at the preoperative time point, but patients who sustained a second injury trended toward lower psychological readiness at 12 months compared with noninjured patients (60.9 vs 67.2 points; P = .11). Younger (≤20 years) patients with injury had significantly lower psychological readiness to return to sport than young noninjured patients (60.8 vs 71.5 points; P = .02), but no difference was found in older patients (60.9 vs 64.6 points; P = .58). In younger patients, receiver operating characteristic curve analysis revealed a cutoff score of 76.7 points with 90% sensitivity to identify younger patients who sustained a second ACL injury. CONCLUSION: Younger patients with lower psychological readiness are at higher risk for a second ACL injury after return to sport.
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Authors | April L McPherson, Julian A Feller, Timothy E Hewett, Kate E Webster |
Journal | The American journal of sports medicine
(Am J Sports Med)
Vol. 47
Issue 4
Pg. 857-862
(03 2019)
ISSN: 1552-3365 [Electronic] United States |
PMID | 30753794
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adolescent
- Adult
- Anterior Cruciate Ligament Injuries
(psychology, surgery)
- Anterior Cruciate Ligament Reconstruction
(psychology)
- Fear
- Female
- Follow-Up Studies
- Humans
- Male
- Prospective Studies
- Recurrence
- Return to Sport
(psychology)
- Young Adult
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