Psychological readiness at 9 months after anterior cruciate ligament reconstruction -which factors affect?

Abstract

Objective: To investigate the association of psychological readiness at 9 months after anterior cruciate ligament reconstruction (ACLR) with knee strength and range-of-motion (ROM) at 3 and 9 months postoperatively.

Design: Retrospective cohort study.

Setting: Private orthopedic hospital.

Participants: Seventy-eight patients after ACLR.

Main outcomes measures: The participants completed the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale as an assessment of psychological readiness at 9 months after ACLR. Isometric and isokinetic quadriceps and hamstring strength were measured by a dynamometer at 3 and 9 months postoperatively. Knee extension and flexion ROM were measured in 5° increments with a standard goniometer at 3 and 9 months postoperatively.

Results: Univariate regression analysis showed that age, limb symmetry index (LSI) of quadriceps strength at 3 and 9 months, and knee extension ROM deficit (>5°) at 3 and 9 months were associated with ACL-RSI scores at 9 months (P < 0.05). Age and LSI of quadriceps strength at 3 months remained significant predictors of ACL-RSI scores at 9 months in multiple regression analysis (R² = 0.20, P < 0.001).

Conclusions: Early improvements in quadriceps strength after ACLR may have a positive impact on psychological readiness at 9 months postoperatively.

Keywords: Anterior cruciate ligament reconstruction; Psychological readiness; Quadriceps strength; Return to sport.