Patient expectations of primary and revision anterior cruciate ligament reconstruction

Feucht, Matthias J.; Cotic, Matthias; Saier, Tim; Minzlaff, Philipp; Plath, Johannes E.; Imhoff, Andreas B.; Hinterwimmer, Stefan

doi:10.1007/s00167-014-3364-z

Cited by 191 publications

(182 citation statements)

References 40 publications

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“…Rehabilitation is frequently focused on specific joint and functional parameters (6-9), often not considering psychological issues. On the other hand, physical and mental issues are strictly connected and complementary in the human being (10)(11)(12)(13). The improvement of psychological status influences the somatic status.…”

Section: Introductionmentioning

confidence: 99%

Videoinsight®: A New Psychological Enhancing Method to Speed-up Recovery After Orthopedic Surgery

Russo¹,

Zaffagnini

2015

Middle East J Rehabil Health Stud

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Videoinsight® means to gain insight by looking at a work of contemporary art. It focuses on the aim and the psychological effect that are potentially provoked by the interaction with some selected contemporary works of art. The insight promoted by the work of art is the outcome of the activation of transference, of projections and reflections on the artistic product, of the unconscious elaboration that leads to the development of transformation. Videoinsight® is a theoretical concept, a working method and a psychological process. It is based on the experience of exchange and integration between the contemporary artwork and the psychology of individuals who relate to it. Some works of contemporary art provoke and stimulate the psyche and activate psychological mechanisms. They trigger an intellectual and emotional experience: they make us think and feel a certain way. Interacting with selected works of art leads to the development and activation of human potentials. The Videoinsight® method can be applied in prevention, diagnosis, psychological support and psychotherapy for treatment of all psychological and psychosomatic diseases. It has been already applied in Medical Orthopedic Researches for rehabilitation and psychological support.

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Section: Introductionmentioning

confidence: 99%

Videoinsight®: A New Psychological Enhancing Method to Speed-up Recovery After Orthopedic Surgery

Russo¹,

Zaffagnini

2015

Middle East J Rehabil Health Stud

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“…The high rates of chondral lesions observed at the time of revision ACLR may be associated with the high rates of osteoarthritis development following revision ACLR (Salmon, Pinczewski, Russell, & Refshauge, 2006). Despite an overall reduction in patient expectations for revision ACLR compared to the very high expectations reported prior to primary ACLR, 96% of patients expect no risk or a slightly increased risk of developing osteoarthritis (compared to a healthy knee) 10 years following revision ACLR, 88% percent expect to return to the same level of sport, and all patients expect to have a normal or nearly normal knee after revision surgery (Feucht et al, 2014). In contrast to these expectations, only one in every two patients return to pre-injury sport following revision ACLR (Grassi et al, 2015) and reported rates of knee osteoarthritis four to eight years after revision ACLR range from 37% to 80% (Kamath, 2011).…”

Section: Subsequent Injury and Revision Surgerymentioning

confidence: 99%

“…Factors associated with a reduced likelihood of returning to sport included older age at the time of ACLR, female sex, participating in non-elite sport, a high fear of re-injury, low psychological readiness to return to sport and negative emotional responses to ACLR (Ardern, Taylor, Feller, & Webster, 2012a;Ardern et al, 2014b). Despite the low rates of return to sport reported in the literature, as many as 91% of patients expect to return to pre-injury sport within one year of ACLR (Feucht et al, 2014). This mismatch between return to sport expectations and actual return to sport rates could negatively impact on QOL and postoperative satisfaction.…”

Section: Return To Pre-injury Sportmentioning

confidence: 99%

“…Although the overall ACLR surgical procedure has vastly reduced in invasiveness with the adoption of arthroscopic surgery and the cessation of open surgical techniques, a patient undergoing an ACLR can expect at least a short-term period of moderate to severe pain and joint inflammation and a prolonged period of altered weight bearing and limited function. Despite these post-operative difficulties, a common rationale for undergoing ACLR is that the procedure will improve knee stability, enabling an eventual return to unrestricted sport, and reducing the risk of additional knee injury and subsequent knee osteoarthritis (Feucht et al, 2014;Marx et al, 2003;Matava, Howard, Polakof, & Brophy, 2014).…”

Section: Anterior Cruciate Ligament Reconstructionmentioning

confidence: 99%

“…The primary treatment for ACL rupture offered to people who wish to return to sport is a surgical reconstruction of the ACL (Marx et al, 2003), with the majority of patients expecting to return to sport within one year of surgery (Feucht et al, 2014). Many individuals do not return to competitive sport after ACLR (Ardern et al, 2014b) despite most ACL ruptures occurring during competitive sport participation (Gianotti et al, 2009).…”

Section: Summary and Thesis Aimsmentioning

confidence: 99%

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Long-term quality of life following anterior cruciate ligament injury and reconstruction

Filbay¹

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The anterior cruciate ligament (ACL) serves to stabilise the knee complex and prevent intraarticular knee structures from sustaining damage during multiaxial, high impact movement. An ACL rupture most commonly occurs in adolescents and young adults taking part in competitive sports and causes substantial disruption to the knee joint. Anterior cruciate ligament reconstruction (ACLR) is the most common treatment offered to ACL-ruptured individuals worldwide. Individuals undergoing this surgery often have high expectations that rarely match surgical outcomes. Return to sport rates are low, re-injury fears are widespread and many individuals develop knee osteoarthritis within ten years of ACLR. This mismatch between expectations and actual outcomes has great potential to impact longer-term quality of life (QOL). The primary aims of this thesis were to: (i) generate a detailed picture of longer-term QOL following ACLR, and (ii) identify factors related to longer-term QOL in people with knee pain, symptoms or functional limitations following ACLR.The first study in this thesis is a systematic review that revealed impaired knee-related QOL at 5 to 20 years after ACLR. However, it became evident that research into factors impacting upon QOL in this population was scarce. The systematic review found that having a subsequent knee injury, an additional knee surgery after ACLR, and developing severe radiographic osteoarthritis were associated with worse QOL outcomes. The second study in this thesis is a systematic review that investigated QOL more than five years after ACL rupture in individuals who remained ACL-deficient (did not undergo ACLR) and compared QOL between ACLdeficient and ACL-reconstructed groups. This systematic review found that ACL-deficient individuals reported comparable QOL outcomes to those who underwent ACLR 5 to 25 years previously. All studies that reported QOL after ACLR included asymptomatic participants without knee difficulties, which may underestimate the degree of QOL impairment experienced by people with ongoing knee difficulties.The third study in this thesis used a cross-sectional design to describe QOL outcomes in 162 individuals with knee pain, symptoms or functional limitations 5 to 20 years following ACLR.It showed that individuals who did not return to sport after ACLR reported poorer knee-related and health-related QOL, compared to people who returned to pre-injury levels of sport. Higher body mass index (BMI) and subsequent surgery were also related to worse QOL after ACLR.This was the first study to show that return to sport was associated with QOL impairment more than five years after ACLR. However, quantitative assessment of QOL may overlook important considerations with regard to an individual's life priorities, expectations, values and concerns.To provide a detailed understanding of QOL following ACLR, qualitative interviews were performed with 17 individuals with knee difficulties 5 to 20 years following ACLR. This was the first qualitative study to explore QOL following...

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Limiting the Risk of Osteoarthritis After Anterior Cruciate Ligament Injury: Are Health Care Providers Missing the Opportunity to Intervene?

Davis

Chahal

Wong

et al. 2021

Arthritis Care & Research

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Objective.To understand what sports orthopedic surgeons (OS), primary care physicians (PCPs) with sports medicine training, and physical therapists (PTs) managing nonelite athletes with anterior cruciate ligament (ACL) injury tell their patients about their osteoarthritis (OA) risk.Methods. An electronic survey was distributed by the Canadian Academy of Sport and Exercise Medicine (PCPs, OS), the Sports and Orthopedic Divisions of the Canadian Physiotherapy Association (PTs), and to OS identified through the Royal College of Physicians and Surgeons and the Canadian Orthopaedic Association. The survey included 4 sections: demographics, factors discussed, timing of discussions, and discussion of risk factors and their management. Proportions or means with 95% confidence intervals were calculated.Results. A total of 501 health care professionals (HCPs) responded (98 PCPs, 263 PTs, and 140 OS). Of those responding, 70-77% of physicians reported always discussing OA risk, but only 35% of PTs did. All HCPs reported that patient activities perceived as detrimental to knee health, ACL reinjury, and simultaneous injury to other structures in the knee were most often the reason for discussing OA risk. OA risk was discussed at initial management postinjury (65-94%), with few discussing risk subsequently. Eighty percent of physicians and 99% of PTs indicated that PTs were suited to provide OA risk and management information.Conclusion. HCPs routinely managing people with ACL injury do not consistently discuss OA risk post-injury with them. Educational strategies for HCPs are urgently needed to develop care pathways inclusive of support for OA risk management following ACL injury.

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Patient expectations of primary and revision anterior cruciate ligament reconstruction

Abstract: Prospective case series, Level IV.

Cited by 191 publications

References 40 publications

Videoinsight®: A New Psychological Enhancing Method to Speed-up Recovery After Orthopedic Surgery

Videoinsight®: A New Psychological Enhancing Method to Speed-up Recovery After Orthopedic Surgery

Long-term quality of life following anterior cruciate ligament injury and reconstruction

Limiting the Risk of Osteoarthritis After Anterior Cruciate Ligament Injury: Are Health Care Providers Missing the Opportunity to Intervene?

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