Cargando…

Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY

OBJECTIVES: Background: Revision ACL reconstruction (ACLR) has demonstrated worse functional outcomes and higher reinjury rates in young patients. Psychological associations with revision surgery have not previously been evaluated. Purpose: To investigate levels of psychological readiness and psycho...

Descripción completa

Detalles Bibliográficos
Autores principales: Milewski, Matthew, Coene, Ryan, Cook, Danielle, Kocher, Mininder, Kramer, Dennis, Micheli, Lyle, Yen, Yi-Meng, Christino, Melissa, Tarchala, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392528/
http://dx.doi.org/10.1177/2325967123S00313
_version_ 1785082983910211584
author Milewski, Matthew
Coene, Ryan
Cook, Danielle
Kocher, Mininder
Kramer, Dennis
Micheli, Lyle
Yen, Yi-Meng
Christino, Melissa
Tarchala, Magdalena
author_facet Milewski, Matthew
Coene, Ryan
Cook, Danielle
Kocher, Mininder
Kramer, Dennis
Micheli, Lyle
Yen, Yi-Meng
Christino, Melissa
Tarchala, Magdalena
author_sort Milewski, Matthew
collection PubMed
description OBJECTIVES: Background: Revision ACL reconstruction (ACLR) has demonstrated worse functional outcomes and higher reinjury rates in young patients. Psychological associations with revision surgery have not previously been evaluated. Purpose: To investigate levels of psychological readiness and psychological stress in young patients after revision ACLR METHODS: Patients, ages 10-35, were enrolled who underwent revision ACLR at one center by one of six surgeons. Psychological readiness and psychological stress was assessed 6-months post- operatively with the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and PROMIS- Psychological Stress Experiences (PROMIS-PSE), respectively. The International Knee Documentation Committee (IKDC/Pedi-IKDC), and Hospital for Special Surgery Pediatric Functional Activity Scale (HSS Pedi-FABS) were also collected. Patient reported outcomes of revision ACLR patients were compared to a cohort of primary ACLR patients. Propensity score matching 3:1 was performed for age, sex, and graft type. RESULTS: Matching resulted in 81 ACLR patients (57 primary and 24 revision). Mean age in the revision group was 18.6 ± 3.2 (66.7% female). The most common graft type in both the primary and revision group was BTB (65% and 67%, respectively) (Table 1). Mild negative correlation was detected between IKDC and PROMIS PSE (r=-0.31; 95% CI=-0.49, -0.10; p=0.005) and a moderate positive correlation was detected between IKDC and ACL-RSI scores (r=0.56; 95% CI=0.39, 0.70; p<0.001). Revision ACLR patients had lower psychological readiness scores (47 vs. 64, p=0.004) and lower IKDC/Pedi-IKDC scores (72 vs 78, p=0.05), compared to primary ACLR patients. Revision ACLR patients also had longer return to sports clearance compared to primary ACLR (median, 10 months vs 8 months; p=0.02). Regression analysis showed revision patients could expect a 15-point decrease in ACL RSI scores compared to patients who underwent primary ACLR surgery (95% CI=-25.30, -4.21; p=0.007). Furthermore, revision patients also could expect a 1.4 month longer return to sports clearance date compared to primary ACLR patients (95% CI=0.29, 2.60; p=0.01). No differences were noted in Pedi- FABS or PROMIS-PSE scores between revision and primary patients (Table 2). CONCLUSIONS: This study is the first to date to examine psychological readiness to return to sport in young patients after revision ACLR. At 6-months post-surgery, revision ACLR patients had lower psychological readiness scores, inferior knee functional outcomes scores, and delayed return to sport clearance. Greater attention to the psychological aspects of recovery in the revision ACLR setting may be important to help optimize post-operative care and outcomes.
format Online
Article
Text
id pubmed-10392528
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-103925282023-08-02 Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY Milewski, Matthew Coene, Ryan Cook, Danielle Kocher, Mininder Kramer, Dennis Micheli, Lyle Yen, Yi-Meng Christino, Melissa Tarchala, Magdalena Orthop J Sports Med Article OBJECTIVES: Background: Revision ACL reconstruction (ACLR) has demonstrated worse functional outcomes and higher reinjury rates in young patients. Psychological associations with revision surgery have not previously been evaluated. Purpose: To investigate levels of psychological readiness and psychological stress in young patients after revision ACLR METHODS: Patients, ages 10-35, were enrolled who underwent revision ACLR at one center by one of six surgeons. Psychological readiness and psychological stress was assessed 6-months post- operatively with the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and PROMIS- Psychological Stress Experiences (PROMIS-PSE), respectively. The International Knee Documentation Committee (IKDC/Pedi-IKDC), and Hospital for Special Surgery Pediatric Functional Activity Scale (HSS Pedi-FABS) were also collected. Patient reported outcomes of revision ACLR patients were compared to a cohort of primary ACLR patients. Propensity score matching 3:1 was performed for age, sex, and graft type. RESULTS: Matching resulted in 81 ACLR patients (57 primary and 24 revision). Mean age in the revision group was 18.6 ± 3.2 (66.7% female). The most common graft type in both the primary and revision group was BTB (65% and 67%, respectively) (Table 1). Mild negative correlation was detected between IKDC and PROMIS PSE (r=-0.31; 95% CI=-0.49, -0.10; p=0.005) and a moderate positive correlation was detected between IKDC and ACL-RSI scores (r=0.56; 95% CI=0.39, 0.70; p<0.001). Revision ACLR patients had lower psychological readiness scores (47 vs. 64, p=0.004) and lower IKDC/Pedi-IKDC scores (72 vs 78, p=0.05), compared to primary ACLR patients. Revision ACLR patients also had longer return to sports clearance compared to primary ACLR (median, 10 months vs 8 months; p=0.02). Regression analysis showed revision patients could expect a 15-point decrease in ACL RSI scores compared to patients who underwent primary ACLR surgery (95% CI=-25.30, -4.21; p=0.007). Furthermore, revision patients also could expect a 1.4 month longer return to sports clearance date compared to primary ACLR patients (95% CI=0.29, 2.60; p=0.01). No differences were noted in Pedi- FABS or PROMIS-PSE scores between revision and primary patients (Table 2). CONCLUSIONS: This study is the first to date to examine psychological readiness to return to sport in young patients after revision ACLR. At 6-months post-surgery, revision ACLR patients had lower psychological readiness scores, inferior knee functional outcomes scores, and delayed return to sport clearance. Greater attention to the psychological aspects of recovery in the revision ACLR setting may be important to help optimize post-operative care and outcomes. SAGE Publications 2023-07-31 /pmc/articles/PMC10392528/ http://dx.doi.org/10.1177/2325967123S00313 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
spellingShingle Article
Milewski, Matthew
Coene, Ryan
Cook, Danielle
Kocher, Mininder
Kramer, Dennis
Micheli, Lyle
Yen, Yi-Meng
Christino, Melissa
Tarchala, Magdalena
Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY
title Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY
title_full Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY
title_fullStr Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY
title_full_unstemmed Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY
title_short Poster 347: PSYCHOLOGICAL READINESS AFTER REVISION ACL RECONSTRUCTION: A ROAR STUDY
title_sort poster 347: psychological readiness after revision acl reconstruction: a roar study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392528/
http://dx.doi.org/10.1177/2325967123S00313
work_keys_str_mv AT milewskimatthew poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT coeneryan poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT cookdanielle poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT kochermininder poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT kramerdennis poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT michelilyle poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT yenyimeng poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT christinomelissa poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy
AT tarchalamagdalena poster347psychologicalreadinessafterrevisionaclreconstructionaroarstudy