Summary
A mismatch between physical function and psychological status at return to sport after ACL reconstruction does not significantly affect risk for a second ACL injury.
Abstract
Purpose
This study aimed to investigate whether a mismatch between physical function and psychological outcomes at return to pre-injury level of sport (RTS) after anterior cruciate ligament (ACL) reconstruction is associated with the risk of a second ACL injury.
Methods
Patients registered in a local rehabilitation specific registry, aged 15–40 years, who had undergone primary ACL reconstruction, reported a pre-injury Tegner level =6, and completed muscle function tests and patient reported outcome measures (PROs) at RTS were included. Based on results from tests of muscle function and answer to PROs, patients were categorized into four groups: (1) high physical function and high PROs (High-High), (2) low physical function and low PROs (Low-Low), (3) high physical function and low PROs (High-Low), and (4) low physical function and high PROs (Low-High). Cox regression analysis and Kaplan-Meier survival estimates were used to assess the association between group classification and second ACL injury risk within one year of RTS.
Results
A cohort of 380 patients from was included. Within one year of RTS, 34 (8.9%) patients sustained a second ACL injury. The second ACL injury rate was highest in the Low-High group (19.2%). However, no statistically significant difference in hazard ratios for second ACL injury was observed.
Conclusion
A “mismatch” that consist of high muscle function but low psychological status, or low muscle function and high psychological status does not appear to affect the occurrence of a subsequent ACL injury after ACL reconstruction.