Determinants of apprehension to return to sport after reconstruction of the anterior cruciate ligament: an exploratory observational retrospective study

Alexandre Martini (1) , Anne Ayala , Marc Lechable (1, 2) , François Rannou (1, 3, 2) , Marie-Martine Lefèvre-Colau (1, 3, 4, 5) , Christelle Nguyen (1, 3, 2)

1 Service de rééducation et de réadaptation de l'appareil locomoteur et des pathologies du rachis [CHU Cochin]
2 T3S - UMR_S 1124 - Toxicité environnementale, cibles thérapeutiques, signalisation cellulaire
3 UFR Médecine UPCité - UFR Médecine [Santé] - Université Paris Cité
4 ECaMO - [CRESS - U1153 / UMR_A 1125] - Clinical Epidemiology Applied to Osteoarticular Diseases | Épidémiologie clinique appliquée aux maladies rhumatismales et musculo-squelettiques
5 IFRH / RFRH - Institut fédératif de recherche sur le handicap / Réseau fédératif de recherche sur le handicap

Background: Only 65% of people return to a level of sport equivalent to that before after anterior cruciate ligament (ACL) surgery. Persisting apprehension may in part explain this observation. We aimed to describe characteristics of people with ACL-Return to Sport after Injury (RSI) scores ≥ 60/100 (low apprehension) at 6 months after injury and to identify variables independently associated with low apprehension at 6 months. Methods: We conducted a single-center retrospective study. People who had surgery for an ACL rupture and who participated in an outpatient post-operative rehabilitation program were included consecutively. The ACL-RSI questionnaire was self-administered at 6 months after injury. Baseline characteristics of people with ACL-RSI scores ≥ 60/100 and < 60/100 were described. Multiple logistic regression was performed to identify baseline variables associated with low apprehension at 6 months. Results: We included 37 participants: 13/37 (35.1%) were women and mean age was 27.2 (9.2) years. At 6 months, 21/37 (56.8%) had an ACL-RSI score ≥ 60/100. Participants who had an ACL-RSI score ≥ 60/100 more often received a preoperative rehabilitation (16/21 [76.2%] vs 5/16 [31.2%]), and had less often knee pain (7/21 [33.3%] vs 7/16 [43.7%]) and effusion (5/21 [23.8%] vs 8/16 [50.0%]) at 1 month after surgery, than participants who had an ACL-RSI score < 60/100. In the multivariate analysis, preoperative rehabilitation was associated with low apprehension at 6 months (OR [95% CI] = 0.107 [0.023 to 0.488], p = 0.002). Conclusions: Preoperative rehabilitation was independently associated with low apprehension at 6 months. Trial registration. Not applicable.

Mots clés: Anterior cruciate ligament injury; Return to sport; Apprehension

Domaines: Sciences du Vivant [q-bio]

Alexandre Martini, Anne Ayala, Marc Lechable, François Rannou, Marie-Martine Lefèvre-Colau, et al.. Determinants of apprehension to return to sport after reconstruction of the anterior cruciate ligament: an exploratory observational retrospective study. BMC Sports Science, Medicine and Rehabilitation, 2022, 14, pp.37. ⟨10.1186/s13102-022-00433-1⟩. ⟨hal-03671557⟩