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Psychosocial factors 3‐months after anterior cruciate ligament reconstruction predict 6‐month subjective and objective knee outcomes
Author(s) -
Erickson Lauren N.,
Jacobs Cale A.,
Johnson Darren L.,
Ireland Mary L.,
Noehren Brian
Publication year - 2022
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.25120
Subject(s) - medicine , anterior cruciate ligament , return to sport , anterior cruciate ligament reconstruction , isometric exercise , physical therapy , psychosocial , osteoarthritis , quality of life (healthcare) , hamstring , athletes , acl injury , physical medicine and rehabilitation , surgery , nursing , pathology , alternative medicine , psychiatry
The objective of the study was to determine if psychological readiness for sport and knee self‐efficacy assessed early (3 months) after anterior cruciate ligament reconstruction (ACLR) are predictive of self‐reported functional outcomes, quadriceps strength, and knee mechanics while running at the time of return to sport training (6 months). Thirty athletes with unilateral ACLR completed the ACL Return to Sport after Injury (ACL‐RSI) and Knee Self‐Efficacy Scale (K‐SES) 3 months after ACLR and completed self‐reported functional outcomes, isometric quadriceps strength testing, and three‐dimensional running gait analysis 6 months after ACLR. The 3‐month ACL‐RSI significantly correlated with the 6‐month International Knee Documentation Committee (IKDC; r = 0.565, p = 0.001), Knee Injury and Osteoarthritis Outcome Score (KOOS) sport/recreational activities (KOOS Sport ; r = 0.548, p = 0.002) and quality of life (KOOS QoL ; r = 0.431, p = 0.017), and quadriceps strength ( r = 0.528, p = 0.003). The 3‐month K‐SES significantly correlated with the 6‐month IKDC ( r = 0.528, p = 0.003), KOOS Sport ( r = 0.430, p = 0.018), KOOS QoL ( r = 0.411, p = 0.024), quadriceps strength ( r = 0.465, p = 0.010), and knee flexion excursion ( r = 0.472, p = 0.008). With multivariate modeling, both the ACL‐RSI and K‐SES were predictive of the IKDC ( R 2 = 0.411; p = 0.001). Only the ACL‐RSI was predictive of the KOOS Sport ( R 2 = 0.300; p = 0.002), KOOS QoL ( R 2 = 0.186; p = 0.017), and quadriceps strength ( R 2 = 0.279; p = 0.003), whereas only the K‐SES was predictive of knee flexion excursion ( R 2 = 0.173; p = 0.022). Athletes with greater psychological readiness for sport and knee self‐efficacy at 3 months demonstrated higher scores on self‐reported functional outcomes, greater quadriceps strength, and greater knee flexion excursion at 6 months after ACLR. This study indicates that psychosocial measures may be important to include into early post‐surgical evaluations to help guide and facilitate interventions to restore subjective and objective knee function.