Depression and psychiatric disease associated with outcomes after anterior cruciate ligament reconstruction

Abstract

While most patients with an anterior cruciate ligament (ACL) injury indicate satisfaction with surgical intervention, a significant proportion still do not return to pre-injury level of function or sport. Psychiatric comorbidities, such as depression, have recently been associated with poor clinical outcomes after ACL reconstruction (ACLR). To date, no article has yet examined how depression affects ACLR outcomes and how potential screening and intervention for psychological distress may affect postoperative activity level. The purpose of this review is to delineate potential relationships between depression and ACLR outcome, discuss clinical implications and identify future directions for research.

Patient-Related Risk Factors for Contralateral Anterior Cruciate Ligament (ACL) Tear after ACL Reconstruction: An Analysis of 3707 Primary ACL Reconstructions

“…While recent studies have reported that patients who sustain ACL injuries may report higher rates of symptoms of depression and that such disorders may be associated with worse post-operative outcome scores and lower rates of return to play, no studies to date have examined if depression increases the risk of contralateral ACLR. Our study found that a history of depression nearly doubles the odds of contralateral ACLR after primary reconstruction [23]. The mechanism behind such a relationship is likely multifactorial and complex.…”

“…The mechanism behind such a relationship is likely multifactorial and complex. Adhering to post-operative rehabilitation protocols after ACLR has been shown to correlate with reported outcomes and recurrent injury [2, 23]. Thus, depressed patients may have a more difficult time adhering to or completing ACL rehabilitation and might therefore be at increased risk for contralateral injury when returning to sport.…”

Noncontact Knee Ligament Injury Prevention Screening in Netball: A Clinical Commentary with Clinical Practice Suggestions for Community-Level Players

“…29 Anterior cruciate ligament and meniscus injuries result in profound consequences such as physical disability, 28,30 substantial healthcare costs, [29][30][31][32] disrupted academic studies, 33,34 premature retirement from netball, 35 post-trauma osteoarthritis, 36,37 and depression. 38,39 Risk of suicide can also exist after sports injuries. 40,41 Because of such consequences, interventions are needed to mitigate the burden of knee ligament injury for players, teams, and society, and prolong players' safe netball participation across the lifespan.…”

REAC neurobiological treatments in acute post-traumatic knee medial collateral ligament lesion

“…Therefore, it would be useful a rehabilitative approach which aims at recovering not only the outcomes of the physical trauma, such as injured tissues, but also the neuropsychical state that can condition the complete recovery [ 7 , 10 ]. Recent studies show that people suffering joint lesions tend to experience more depression [ 11 , 12 ], anxiety [ 13 ], emotional impairment [ 14 ], have a fear of re-injury [ 15 , 16 , 17 ], have decreased sport satisfaction [ 17 ]. This would suggest that joint lesions produce not only a physical but also a neuropsychical impact on injured people.…”