‘I was young, I wanted to return to sport, and re-ruptured my ACL’ – young active female patients’ voices on the experience of sustaining an ACL re-rupture, a qualitative study

Abstract

Background Despite anterior cruciate ligament (ACL) re-ruptures being common, research on patient experiences after knee trauma has primarily focused on the time after primary ACL reconstruction. Integrating qualitative research and patient experiences can facilitate researchers and clinicians in understanding the burden of an ACL re-rupture. The aim of the study was to explore the experiences of an ACL re-rupture journey in young active females aiming to return to knee-strenuous sports after primary ACL reconstruction. Method Fifteen young (19[range 16–23] years old) active females who suffered an ACL re-rupture were interviewed with semi-structured interviews. Qualitative content analysis using deductive approach based on Wiese-Bjornstal’s ‘integrated model of response to sport injury’ was used. Results The results are presented in two timelines 1) from first ACL injury to ACL re-rupture, and 2) from ACL re-rupture to present day, and further stratified according to the domains of the ‘integrated model of psychological response to injury’. Results in the first timeline are summarised into seven categories: Finding hope for the journey; Accepting my ACL injury; I succeeded; What matters now? Who am I?; Where will this end? What is going to happen? In the second timeline, eight categories were identified: Fighting spirit; A helping hand; Working hard; I am a new me; I am destroyed; Loneliness; Painful changes; and, I could have made it to the pro´s. Conclusion Young active females who suffered an ACL re-rupture did not express any positive experience following their first ACL injury, however, in contrast, expressed positive experiences and personal growth after going through the ACL re-rupture journey, characterized by a lot of struggling, and ultimately led to the experience of becoming a new, stronger person.

The Influence of Psychosocial Factors on Patients Undergoing Anterior Cruciate Ligament Reconstruction

“…Patients' descriptions of feelings include: burden, worry, frustration, hopelessness, devastation, and isolation. 23,30,36,52,68 Mental health conditions, such as anxiety and depression, may increase in severity in response to injury and be detrimental to outcomes. 46 Schaffer et al 58 observed outcomes of patients stratified into 3 cohorts: clinical diagnosis of depression, situational depression, and no depression.…”

“…55,66 However, on-field and competitive rehabilitation activities should be practiced with caution; some patients find the experience demotivating when unable to contribute or keep up. 52,55 Interactions with coaches also contribute heavily. The authority and confidence they hold gives them the opportunity to encourage and motivate athletes, especially when they are involved in recovery and RTS decisions.…”

“…Patients develop confidence, self-efficacy, and trust throughout the process. 33,52 Successful recoveries often have stronger social networks and psychosocial resources. 33 Some embrace an athletic identity as motivation to endure, whereas others favor nonathletic identities as they reprioritize their lives.…”

“…33 Some embrace an athletic identity as motivation to endure, whereas others favor nonathletic identities as they reprioritize their lives. 52 Career setbacks, commitments, and time constraints alter behavior, affecting initial recovery and future risk appraisal. Further, diminished mobility often affects social interactions, shifting perception and expectations among friends and strangers.…”

Warum wir einen psychologisch informierten Ansatz in der Rehabilitation von VKB-Verletzungen brauchen!

“…In diesem Zusammenhang ist von großer Bedeutung, dass viele Sportler ihr Selbstwertgefühl in einem hohen Maß durch die Partizipation und die Anerkennung innerhalb des Sports erfahren. Eine Sportkarenz geht daher fast immer mit einer Herabsetzung der eigenen Wertschätzung bis hin zur Zerstörung der eigenen Identität einher [36] [61].…”