Greater Psychological Readiness to Return to Sport, as Well as Greater Present and Future Knee-Related Self-Efficacy, Can Increase the Risk for an Anterior Cruciate Ligament Re-Rupture: A Matched Cohort Study

Piussi, Ramana; Beischer, Susanne; Thomeé, Roland; Thomeé, Christoffer; Sansone, Mikael; Samuelsson, Kristian; Senorski, Eric Hamrin

doi:10.1016/j.arthro.2021.08.040

Cited by 41 publications

(35 citation statements)

References 32 publications

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“…the strongest association with the outcome, whereas ACL-RSI was not selected with the longer follow-up times. Previous studies have shown an association with ACL-RSI and second ACL injury in follow-up periods of approximately 2 years after ACLR [ 37 , 38 ], indicating that psychological readiness for RTS may be more important in the short-term follow-up. This confirms the hypothesis that the association between psychological readiness and injury will decrease with longer follow-up times.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Sustaining a Second ACL Injury after Primary ACL Reconstruction in Female Football Players: A Study Investigating the Effects of Follow-Up Time and the Statistical Approach

et al. 2023

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Background Studies evaluating risk factors for sustaining an anterior cruciate ligament (ACL) injury have different, sometimes contrasting, results. Different follow-up times and statistical approaches may be a reason for these differences. The aim of this study was to explore if different follow-up times and statistical approaches, classification and regression tree (CART) analysis and Cox regression, would impact on the association between various candidate risk factors and ACL injury in female football players. In total, 112 active female football players, 18 ± 8 months after ACL reconstruction (mean age ± SD, 20 ± 2 years), were included and followed for at least 36 months. At baseline, all players underwent assessment of range of motion of knee and ankle joints, functional tests, and answered questionnaires regarding knee function, psychological and personality traits. Nineteen independent variables were included for the CART analysis and for univariable Cox regression and compared using four different follow-up times: 0–12, 0–24, 0–36, and 0–>36 months. Results Forty-three (38%) players sustained a second ACL injury. The identified risk factors varied depending on follow-up time both with CART analysis and with Cox regression. CART identified 12 of the 19 independent variables and selected between 5 and 6 of the variables in the four different follow-up times associated with second ACL injury. The accuracy of the different follow-up times for the CART varied between 86 and 93% with 77–96% sensitivity and 70–81% specificity. Cox regression identified two risk factors: knee extension at 0–36 months and 0–>36 months, and time between primary injury and surgery at 0–>36 months. The accuracy varied between 54 and 64% with 44–88% sensitivity and 32–71% specificity. Conclusions The identified risk factors associated with a second ACL injury varied depending on the follow-up time and statistical approach used. Thus, in future research on risk factors, the time athletes are followed up and the type of statistical methods used are important to discuss.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Sustaining a Second ACL Injury after Primary ACL Reconstruction in Female Football Players: A Study Investigating the Effects of Follow-Up Time and the Statistical Approach

et al. 2023

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“…Finally, the incorporation of data from non-operatively treated ACL-injured patients, rehabilitation-specific registries assessing psychometric PROMs, measures of risk appraisal, and muscle function [ 52 , 53 ] will open new avenues for the evaluation of ACL injury treatment outcomes. Merger of data from registries with different aims will provide a more complete picture of the operative and postoperative course of ACL-R patients and permit more complex analyses of outcomes following ACL surgery.…”

Section: Methods Used In Registry Studiesmentioning

confidence: 99%

Scoping Review on ACL Surgery and Registry Data

Kaarre

Zsidai

Narup

et al. 2022

Curr Rev Musculoskelet Med

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Purpose of Review To present an overview of registry-based anterior cruciate ligament (ACL) research, as well as provide insight into the future of ACL registries. Recent Findings During the past decades, the ACL registries have had an important role in increasing our understanding of patients with ACL injuries and their treatment. The registry data has deepened our understanding of factors that have been associated with an increased risk of sustaining an ACL injury and for evaluation of treatment factors and their impact on patient-related outcomes. Recently, registry-based ACL research using artificial intelligence (AI) and machine learning (ML) has shown potential to create clinical decision-making tools and analyzing outcomes. Thus, standardization of collected data between the registries is needed to facilitate the further collaboration between registries and to facilitate the interpretation of results and subsequently improve the possibilities for implementation of AI and ML in the registry-based research. Summary Several studies have been based on the current ACL registries providing an insight into the epidemiology of ACL injuries as well as outcomes following ACL reconstruction. However, the current ACL registries are facing future challenges, and thus, new methods and techniques are needed to ensure further good quality and clinical applicability of study findings based on ACL registry data.

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“…25 Secondly, with regard to PROs, both a relatively negative psychological response (60.8 on the ACL-Return to Sport after Injury (ACL-RSI)) scale and a positive (81.2 on the ACL-RSI) psychological response have been associated with a risk of a second ACL injury. 26,27 Finally, Beischer et al 28 found that patients who RTS < 9 months after ACL reconstruction run a seven times higher risk of suffering a second ACL injury compared with patients who RTS > 9 months after ACL reconstruction, but the results are not always reproduced. 29 As inferior postoperative outcomes have been found in patients with GJH following ACL reconstruction when compared with patients without GJH, 14,15 the presence of GJH might also in uence RTS after ACL reconstruction.…”

Section: Yes/nomentioning

confidence: 99%

Lower rates of return to sport in patients with generalised joint hypermobility two years after ACL reconstruction: a prospective cohort study

Lindskog

Piussi

Simonson

et al. 2023

Preprint

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Background Generalised joint hypermobility (GJH) is associated with an increased risk of suffering an anterior cruciate ligament (ACL) injury. Patients with GJH exhibit lower muscle strength and poorer scores for patient-reported outcomes after ACL reconstruction, compared with patients without GJH. The aim of this study was to examine differences in the percentages of patients who return to sport (RTS) or pre-injury level of activity (RTP), muscle function and patient-reported outcomes at the time of RTS or RTP, as well as the time of RTS or RTP in patients with GJH compared with patients without GJH in the first two years after ACL reconstruction. Methods This prospective study used data from a rehabilitation-specific register. A total of 1,198 patients aged between 16 and 50, who had an ACL injury treated with reconstruction, were included. Data up to two years after ACL reconstruction were used and consisted of results in isokinetic muscle function tests for knee extension and flexion and patient-reported outcomes (Knee Self-Efficacy Scale, Knee injury and Osteoarthritis Outcome Score and ACL-Return to Sport after Injury scale) at the time of RTS, as well as the time of RTP. A Beighton Score of ≥ 5/9 was used to define GJH. A Tegner Activity Scale of ≥ 6 was used to define RTS, while a Tegner equal to or above pre-injury level was used to define RTP. Results A smaller proportion of patients with GJH achieved RTS compared with patients without GJH (49.2% vs 57.3%). Furthermore, patients with GJH were marginally less symmetrical on the knee extension strength test, expressed as a Limb Symmetry Index, at the time of RTP compared with patients without GJH (87.3 ± 13.5 vs 91.7 ± 14.3). No further differences were found between groups regarding any muscle function tests or patient-reported outcomes. Conclusion A smaller proportion of patients with GJH achieved RTS compared with patients without GJH. Patients with GJH display less symmetrical knee extension strength at the time of RTP compared with patients without GJH.

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Greater Psychological Readiness to Return to Sport, as Well as Greater Present and Future Knee-Related Self-Efficacy, Can Increase the Risk for an Anterior Cruciate Ligament Re-Rupture: A Matched Cohort Study

Abstract: Greater psychological readiness to return to sport, as well as greater present and future knee-related self-efficacy can increase the risk for an ACL re-rupture: a matched cohort study,

Cited by 41 publications

References 32 publications

Risk Factors for Sustaining a Second ACL Injury after Primary ACL Reconstruction in Female Football Players: A Study Investigating the Effects of Follow-Up Time and the Statistical Approach

Risk Factors for Sustaining a Second ACL Injury after Primary ACL Reconstruction in Female Football Players: A Study Investigating the Effects of Follow-Up Time and the Statistical Approach

Scoping Review on ACL Surgery and Registry Data

Lower rates of return to sport in patients with generalised joint hypermobility two years after ACL reconstruction: a prospective cohort study

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