Fear of reinjury following primary anterior cruciate ligament reconstruction: a systematic review

Abstract

Purpose This review aims to elucidate the most commonly reported method to quantify fear of reinjury or kinesiophobia and to identify key variables that inluence the degree of kinesiophobia following primary anterior cruciate ligament reconstruction (ACLR). Methods A systematic search across three databases (Pubmed, Ovid (MEDLINE), and EMBASE) was conducted from database inception to August 7th, 2022. The authors adhered to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Quality assessment of the included studies was conducted according to the Methodological Index for Non-Randomized Studies (MINORS) criteria. Results Twenty-six studies satisied the inclusion criteria and resulted in 2,213 total patients with a mean age of 27.6 years and a mean follow-up time of 36.7 months post-surgery. The mean MINORS score of the included studies was 11 out of 16 for non-comparative studies and 18 out of 24 for comparative studies. Eighty-eight percent of included studies used variations of the Tampa Scale of Kinesiophobia (TSK) to quantify kinesiophobia and 27.0% used Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI). The results of this study shows a common association between higher kinesiophobia and poor patient-reported functional status measured using International Knee Documentation Committee (IKDC) Scores, Activity of Daily Living (ADL), Quality of Life (QOL), and Sports/Recreation (S/R) subscales of Knee Osteoarthritis and Outcome Score (KOOS) and Lysholm scores. Postoperative symptoms and pain catastrophizing measured using the KOOS pain and symptom subscales and Pain Catastrophizing Score (PCS) also inluenced the degree of kinesiophobia following ACLR. Patients with an increased injury to surgery time and being closer to the date of surgery postoperatively demonstrated higher levels of kinesiophobia. Less common variables included being a female patient, low preoperative and postoperative activity status and low self-eicacy. ConclusionThe most common methods used to report kinesiophobia following primary ACLR were variations of the TSK scale followed by ACL-RSI. The most commonly reported factors inluencing higher kinesiophobia in this patient population include lower patient-reported functional status, more severe postoperative symptoms such as pain, increased injury to surgery time, and being closer to the date of surgery postoperatively. Kinesiophobia following primary ACLR is a critical element afecting post-surgical outcomes, and screening should be implemented postoperatively to potentially treat in rehabilitation and recovery. Level of evidence IV.

Kinesiophobia contributes to worse functional and patient‐reported outcome measures in Achilles tendinopathy: a systematic review

“…The findings of this study with regard to kinesiophobia and pain are consistent with the literature. In previous studies, kinesiophobia and TSK measures have been shown to be mild‐moderately correlated with pain in patients with shoulder and knee pathology ( r = 0.16–0.43) [3, 24, 37]. Additionally, greater kinesiophobia has been shown to lead to lower quality of life and greater disability in patients with chronic musculoskeletal pain [18].…”

“…Additionally, data were inconsistently reported, with many authors reporting only pooled data, and not responding to requests for primary data tables limiting the ability to perform pooled data analysis. Another limitation was that TSK‐17 and TSK‐11 were both used to assess kinesiophobia, despite both scales being valid and reliable [24]. A major strength of this systematic review is that it includes all relevant literature regarding the effect that kinesiophobia has on physical function performance measures and PROMs.…”

“…Kinesiophobia is defined as a fear of re‐injury or movement, and has an impact on non‐operative management of musculoskeletal pain [24]. The Tampa Scale of Kinesiophobia (TSK‐17) was originally developed for assessing kinesiophobia in chronic back pain patients [36].…”

Increased kinesiophobia leads to lower return to sport rate and clinical outcomes following osteochondral allograft transplantation of the knee

“…Growing evidence suggests psychosocial factors such as kinesiophobia (fear of movement/reinjury), preoperative mental health and pain catastrophizing may influence return to sport [9,10]. While kinesiophobia has been predominantly recognized as affecting outcomes following anterior cruciate ligament reconstruction (ACLR) [11][12][13], shoulder arthroscopy [14][15][16], hip [17] and total knee arthroplasty (TKA) [18,19], there is still limited evidence describing it's effects on RTS and clinical outcomes after OCA transplantation of the knee [20].…”

Posterior tibial slope, notch width index and tibial tubercle to trochlear groove distance contribute to development of mucoid degeneration of the anterior cruciate ligament: a systematic review

“…Whilst these options improve pain and range of motion, instability in the joint tends to appear years after the surgery, with an increased risk of rupture in patients who underwent partial resection [26]. Additionally, it is well known that there are increased psychological symptoms associated with delayed treatment of ACL injuries [21]; therefore, it is important to understand what factors predispose an individual to develop mucoid degeneration of the ACL so that those who are in need of treatment are monitored for early operative management if necessary.…”