Fear of Reinjury (Kinesiophobia) and Persistent Knee Symptoms Are Common Factors for Lack of Return to Sport After Anterior Cruciate Ligament Reconstruction

Greater fear of re-injury and increased tibial translation in patients who later sustain an ACL graft rupture or a contralateral ACL rupture: a pilot study

“…Fear of re-injury is common after ACL reconstruction (Flanigan, Everhart, Pedroza, Smith, & Kaeding, 2013;Heijne, Axelsson, Werner, & Biguet, 2008;Kvist, Ek, Sporrstedt, & Good, 2005), and earlier studies have described its importance for the post-operative outcome. High fear of re-injury has been reported to be associated with worse patient reported and measured knee function (Chmielewski et al, 2008;Hartigan et al, 2013;Lee, Karim, & Chang, 2008;Lentz et al, 2009;te Wierike et al, 2013), and to be correlated to low knee-related quality of life (Kvist et al, 2005) in patients with ACL injury and reconstruction.…”

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

“…Several studies have reported that contextual factors (eg, family commitments, non-knee-related life events) are among the most commonly cited reasons for individuals to postoperatively change or reduce activity levels. 7,22 The present study evaluated activity levels from after return-to-sport clearance to 1 year later to minimize the potential impact of contextual factors regarding postoperative sports participation on the findings, but did not exclude participants due to decreased sports participation for social reasons. Fifth, the current study did not evaluate strength or function at 1 year post return-to-sport clearance.…”

“…A number of studies have found associations between return to sports and psychosocial/psychological variables (kinesiophobia/fear of reinjury, knee-related self-efficacy, confidence). 2,4,5,15,22,35,36 Further evaluation of the impact of these factors, along with that of strength, function, and performance, on return to sports is warranted. Third, only one criterion value (90%) was evaluated in this study, based on what is commonly regarded as acceptable for return-to-sport participation after ACL reconstruction.…”

Biomechanical Adaptations After Fatiguing Exercise in Healthy and ACL Reconstructed Individuals

“…47,65,76,82 Low symmetry (<80%) has also been associated with decreased sagittal plane motion at the knee during walking and jogging gait. 53,56 Quadriceps strength symmetry was also associated with changes in the sagittal plane in the subjects in this study, however in more proximal joints. This may be due to the increased gait speed in our study, causing patients to alter hip and trunk motion rather than knee flexion during high-speed running.…”

“…Sagittal plane adaptations are evident in patients with decreased quadriceps strength, 53,56 however there is limited evidence to support a metric that predicts biomechanical adaptations during exercise both in a rested and fatigued state. Prediction of biomechanical adaptations may help inform decisions regarding the return to unrestricted physical activity in patients with ACLR who are at high risk for subsequent knee injury during sports participation.…”