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Z Orthop Unfall 2024; 162(02): 185-192
DOI: 10.1055/a-1938-8359
Original Article

How Important are Psychological Measures to Determine Readiness to Return to Sports after Reconstruction of the Anterior Cruciate Ligament? An Online Survey Study

Wie wichtig sind psychologische Maßnahmen, um die Bereitschaft zur Rückkehr zum Sport nach der Rekonstruktion des vorderen Kreuzbandes zu bestimmen? Ergebnisse einer Online-Umfrage
Tate Newmarch‡
1   Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Canada (Ringgold ID: RIN7985)
,
Marcel Betsch‡
1   Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Canada (Ringgold ID: RIN7985)
2   Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Mannheim, Mannheim, Germany (Ringgold ID: RIN36642)
,
Roman Michalik 
3   Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Aachen, Aachen, Germany (Ringgold ID: RIN72192)
,
Tim Dwyer
1   Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Canada (Ringgold ID: RIN7985)
,
Daniel Whelan
1   Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Canada (Ringgold ID: RIN7985)
,
Jaskarndip Chahal
1   Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Canada (Ringgold ID: RIN7985)
,
John Theodoropoulos
1   Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Canada (Ringgold ID: RIN7985)
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Abstract

Background Recent studies have suggested that psychological factors are important components of a successful return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to survey physicians with respect to their criteria used to determine readiness to RTS after ACLR and to understand the significance of psychological factors on RTS.

Methods A survey was designed to understand the practices of clinicians managing rehabilitation after ACLR, consisting of 25 questions divided into 3 different sections, including one section about psychological scores and factors affecting RTS. The survey was delivered to three North American organizations for orthopedic sports medicine.

Results The total number of respondents was 113. Of the respondents, 95% considered psychological tests at least “somewhat important” (33% “important”, 23% selected “very important”). Routine use of psychological tests in practice was only reported by 35% of respondents. The ACL-Return to Sport after Injury Scale was the most frequently used psychological test (23%). Fear of reinjury was considered the most common patient-cited psychological factor affecting RTS. Psychological factors ranked 8th out of 9 outcomes measures in determining readiness to RTS.

Conclusion This study demonstrates a discrepancy between the importance of psychological tests and the frequency of use in practice. Additional education on this topic, web-based applications, and a multidisciplinary approach may increase the usage of psychological tests to determine RTS after ACLR.

Zusammenfassung

Hintergrund Psychische Faktoren sind laut neueren Studien wichtige Bestandteile einer erfolgreichen Rückkehr zum Sport (RTS) nach vorderer Kreuzbandrekonstruktion (ACLR). Das Ziel dieser Studie war es, Ärzte hinsichtlich der Kriterien zu befragen, die sie verwenden, um die Bereitschaft zu RTS nach ACLR zu bestimmen und somit die Bedeutung psychologischer Faktoren bei RTS zu verstehen.

Methoden Die Umfrage wurde entwickelt, um den Ansatz von Ärzten zu verstehen, die die Rehabilitation nach ACLR betreuen. Die Umfrage bestand aus 25 Fragen, die in 3 verschiedene Abschnitte unterteilt waren. Ein Abschnitt befasste sich mit psychologischen Werten und Faktoren, die RTS beeinflussen. Die Umfrage wurde an 3 nordamerikanische Organisationen für orthopädische Sportmedizin geliefert.

Ergebnisse Die Gesamtzahl der Befragten lag bei 113, wobei 95% der Befragten psychologische Tests als mindestens „ziemlich wichtig“ einstuften (33% „wichtig“, 23% wählten „sehr wichtig“). Nur 35% der Befragten gaben an, in ihrer Praxis routinemäßig psychologische Tests einzusetzen. Die ACL-„Return-to-Sport-after-Injury-Skala“ war der am häufigsten verwendete psychologische Test (23%). Die Angst vor einer erneuten Verletzung wurde als der am häufigsten von Patienten genannte psychologische Faktor angesehen, der RTS beeinflusst. Psychologische Faktoren belegten den 8. Platz von 9 Ergebnismessungen bei der Bestimmung der Bereitschaft zu RTS.

Fazit Diese Studie zeigt eine Diskrepanz zwischen der Bedeutung psychologischer Tests und der Häufigkeit der Anwendung in der Praxis. Zusätzliche Aufklärung zu diesem Thema, webbasierte Anwendungen und ein multidisziplinärer Ansatz können dazu beitragen, den Einsatz psychologischer Tests zur Bestimmung der Rückkehr zum Sport nach der Rekonstruktion des vorderen Kreuzbandes zu erhöhen.

Keywords

anterior cruciate ligament reconstruction - psychological measures - return to sport - objective criteria

Schlüsselwörter

vordere Kreuzbandrekonstruktion - Rückkehr zum Sport - psychologische Diagnostik - objektive Kriterien


Publication History

Received: 30 January 2022

Accepted after revision: 03 August 2022

Article published online:
20 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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