Factors associated with fear of re-injury in physically active individuals after an anterior cruciate ligament reconstruction

Abstract

Objectives: Fear of re-injury is a psychological consequence of an anterior cruciate ligament (ACL) injury. For physically active individuals, fear of re-injury is a frequent cause for not returning to their preinjury physical activity level after ACL reconstruction. The aim of this study is to investigate fear of re-injury, and factors associated with its increase in physically active individuals who had an ACL reconstruction. Methods: A cross-sectional study was conducted in our institute. An online survey was sent to participants. The survey focused on sports participation and included two instruments, the International Knee Documentation Committee (IKDC) and an 11-item version of the Tampa Scale for Kinesiophobia (TSK-11). Results: In total, 103 individuals participated in this study. The mean age was 35 years, males constituted 98% and the mean body mass index (BMI) was 27.8 kg/m2. The mean post-surgery follow-up period was 5.1 years, and around 59.2% of the sample returned to sports. Soccer was the most frequent (73.8%) sport practiced. The mean TSK-11 was 27.9. Age, BMI, concomitant knee injury, time from injury to surgery, follow-up period, and sport type were not correlated with fear of re-injury. However, sports participation frequency, returning to sports, and IKDC scores were significantly correlated with fear of re-injury. Conclusion: Fear of re-injury after an ACL reconstruction is affected by the frequency of sports participation, resuming activity after injury and knee function. Optimizing these factors may improve the psychological outcomes after an ACL reconstruction.