Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction: expect and motivate to satisfy

Knee Surg Sports Traumatol Arthrosc. 2017 May;25(5):1375-1384. doi: 10.1007/s00167-016-4294-8. Epub 2016 Aug 25.

Abstract

Purpose: To describe individuals' expectations, motivation, and satisfaction before, during, and after rehabilitation for ACL reconstruction and to explore how these factors were associated with return to pre-injury sport activity at 1-year follow-up.

Methods: Sixty-five individuals (34 males), median age 22 (15-45) years, scheduled for ACL reconstruction participated. Participants completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and questions about expectations, satisfaction, and motivation pre-operatively and at 16 and 52 weeks after surgery.

Results: Prior to surgery, 86 % of participants stated that their goal was to return to their pre-injury sport activity. Those who had returned to their pre-injury sport activity at 52 weeks were more motivated during rehabilitation to return to their pre-injury activity level, more satisfied with their activity level and knee function at 52 weeks, and scored significantly higher on the IKDC-SKF [median 92.0 (range 66.7-100.0)] at 52 weeks, compared to those who had not returned [median 77.6 (range 50.6-97.7)].

Conclusion: Prior to ACL reconstruction, most participants expected to return to their pre-injury activity level. Higher motivation during rehabilitation was associated with returning to the pre-injury sport activity. The participants who had returned to their pre-injury sport activity were more satisfied with their activity level and knee function 1 year after the ACL reconstruction. Facilitating motivation might be important to support individuals in achieving their participation goals after ACL reconstruction.

Level of evidence: Prospective cohort study, Level II.

Keywords: ACL; Activity level; Patient perspective; Patient-reported outcome; Psychology; Return to sport.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries / psychology*
  • Anterior Cruciate Ligament Injuries / surgery
  • Anterior Cruciate Ligament Reconstruction / psychology*
  • Anterior Cruciate Ligament Reconstruction / rehabilitation
  • Athletic Injuries / psychology*
  • Athletic Injuries / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Motivation
  • Patient Satisfaction
  • Prospective Studies
  • Return to Sport / psychology*
  • Young Adult