Psychological Readiness and Return to Sport After ACL Reconstruction
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Anterior Cruciate Ligament Injury. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Evaluation of Psychological Readiness, Kinesiophobia, Subjective Knee Function, and Return-to-Sport Status Across Different Postoperative Periods Following Primary Anterior Cruciate Ligament Reconstruction
Overview
The goal of this observational study is to evaluate psychological readiness, kinesiophobia, subjective knee function, sport activity level, and return-to-sport status in athletes who have undergone primary anterior cruciate ligament (ACL) reconstruction between 3 and 24 months after surgery. The main questions it aims to answer are: Do these outcomes differ across different postoperative time periods? Are they associated with return-to-sport status? Participants will complete questionnaires assessing psychological readiness (ACL-RSI), kinesiophobia (TSK), subjective knee function (IKDC), and sport activity level (Tegner), and will provide information about their return-to-sport status.
Detailed description
Anterior cruciate ligament (ACL) injury is one of the most common knee injuries in athletes participating in pivoting and cutting sports. Primary ACL reconstruction is widely performed to restore knee stability, improve functional performance, and facilitate return to sport. Despite advances in surgical techniques and rehabilitation protocols, many athletes do not return to their preinjury level of sports participation. Increasing evidence suggests that successful recovery after ACL reconstruction depends not only on physical function but also on psychological factors.
Psychological readiness to return to sport has emerged as an important determinant of rehabilitation outcomes following ACL reconstruction. Fear of reinjury, lack of confidence in the reconstructed knee, and reduced self-efficacy may delay or prevent return to sport even in individuals who demonstrate satisfactory physical recovery. Patient-reported outcome measures, including the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale, the Tampa Scale for Kinesiophobia (TSK), the International Knee Documentation Committee (IKDC) Subjective Knee Form, and the Tegner Activity Scale, are commonly used to evaluate these psychological and functional aspects of recovery.
Previous studies have reported significant relationships between psychological readiness, kinesiophobia, subjective knee function, and return-to-sport outcomes following ACL reconstruction. However, most investigations have focused on single postoperative time points or relatively homogeneous patient populations. Consequently, limited evidence is available regarding how these outcomes change throughout different stages of postoperative recovery and whether the relationships among these variables differ according to time since surgery.
The aim of this observational cross-sectional study is to evaluate psychological readiness, kinesiophobia, subjective knee function, sport activity level, and return-to-sport status in athletes who have undergone primary ACL reconstruction between 3 and 24 months after surgery. Participants will be classified according to postoperative recovery period, allowing comparisons between different stages of rehabilitation.
Psychological readiness will be evaluated using the ACL-RSI, kinesiophobia using the TSK, subjective knee function using the IKDC Subjective Knee Form, and sport activity level using the Tegner Activity Scale. Information regarding return-to-sport status and relevant demographic and clinical characteristics will also be collected. The study will investigate differences in these outcomes across postoperative recovery periods and examine the relationships between psychological and functional recovery and return-to-sport status.
The findings of this study are expected to improve understanding of the recovery process following ACL reconstruction and provide clinicians with evidence regarding the timing of psychological and functional recovery. The results may contribute to optimizing rehabilitation strategies, identifying athletes who require additional psychological support, and improving clinical decision-making related to return to sport.
Primary outcome measures
- Psychological readiness to return to sport (ACL-RSI) [Time frame: At study assessment (single assessment performed between 3 and 24 months after ACL reconstruction)]
Secondary outcome measures (4)
- Kinesiophobia (Tampa Scale for Kinesiophobia [TSK]) [Time frame: At study assessment (single assessment performed between 3 and 24 months after ACL reconstruction)]
- Subjective knee function (International Knee Documentation Committee [IKDC] Subjective Knee Form) [Time frame: At study assessment (single assessment performed between 3 and 24 months after ACL reconstruction)]
- Sport activity level (Tegner Activity Scale) [Time frame: At study assessment (single assessment performed between 3 and 24 months after ACL reconstruction). Preinjury and current Tegner scores will be recorded to evaluate changes in activity level following primary ACL reconstruction.]
- Return-to-sport status [Time frame: At study assessment (single assessment performed between 3 and 24 months after primary ACL reconstruction)]
Eligibility criteria
Inclusion criteria
- Age ≥18 years.
- History of unilateral primary anterior cruciate ligament (ACL) reconstruction.
- Between 3 and 24 months after ACL reconstruction at the time of assessment.
- Regular participation in sports before ACL injury with a preinjury Tegner Activity Scale score of ≥4.
- Ability to read and understand Turkish and independently complete the study questionnaires.
- Willingness to participate in the study.
- Provision of written informed consent.
Exclusion criteria
- Revision ACL reconstruction.
- Reinjury or graft rupture of the reconstructed ACL.
- Bilateral ACL injury.
- History of ACL reconstruction in the contralateral knee.
- Concomitant major ligament, cartilage, bone, or extensor mechanism surgery that is expected to substantially affect rehabilitation, weight-bearing status, return-to-sport timing, or knee function following primary ACL reconstruction.
- Other lower-extremity injuries or surgical conditions unrelated to ACL reconstruction that limit sports participation at the time of assessment.
- Neurological, rheumatologic, cardiopulmonary, or other severe systemic diseases that substantially limit sports participation.
- Cognitive, psychiatric, or communication disorders that preclude reliable completion of the study questionnaires.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Turkey (Türkiye) · 1 center
- Istanbul University — Istanbul
Publications
- Alswat MM, Khojah O, Alswat AM, Alghamdi A, Almadani MS, Alshibely A, Dabroom AA, Algarni HM, Alshehri MS. Returning to Sport After Anterior Cruciate Ligament Reconstruction in Physically Active Individuals. Cureus. 2020 Sep 15;12(9):e10466. doi: 10.7759/cureus.10466. PMID 33083169
- Ohji S, Aizawa J, Hirohata K, Ohmi T, Mitomo S, Koga H, Yagishita K. Changes in subjective knee function and psychological status from preoperation to 6 months post anterior cruciate ligament reconstruction. J Exp Orthop. 2022 Dec 1;9(1):114. doi: 10.1186/s40634-022-00551-2. PMID 36454346
- Raizah A, Alhefzi A, Alshubruqi AAM, Hoban MAMA, Ahmad I, Ahmad F. Perceived Kinesiophobia and Its Association with Return to Sports Activity Following Anterior Cruciate Ligament Reconstruction Surgery: A Cross-Sectional Study. Int J Environ Res Public Health. 2022 Aug 30;19(17):10776. doi: 10.3390/ijerph191710776. PMID 36078492
- Webster KE, Feller JA, Lambros C. Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery. Phys Ther Sport. 2008 Feb;9(1):9-15. doi: 10.1016/j.ptsp.2007.09.003. Epub 2007 Nov 5. PMID 19083699
- Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011 Jun;45(7):596-606. doi: 10.1136/bjsm.2010.076364. Epub 2011 Mar 11. PMID 21398310
Identifiers
NCT: NCT07733895 · ACL-RTS-2026