Unit of Physiotherapy, Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden.
Center for Medical Image Science and Visualization (CMIV), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Sports Health. 2023 Mar-Apr;15(2):176-184. doi: 10.1177/19417381221094780. Epub 2022 May 27.
The limited research on prognosis after nonsurgical management of anterior cruciate ligament (ACL) injury has focused on physical factors. We aimed to assess relationships between key patient-reported outcomes, in line with a biopsychosocial approach, and returning to preinjury sport at 12 months after ACL injury treated without reconstruction.
We hypothesized that biopsychosocial factors would be associated with returning to preinjury sport at 12 months after ACL injury.
Prospective single cohort study.
Level 2.
Patients who had an ACL injury and did not have reconstruction during the first year after injury were recruited from healthcare clinics in Sweden, and followed up at 3, 6, and 12 months after injury. Return to preinjury sport at 12 months was the primary outcome. Explanatory variables were psychological readiness to return to sport, knee-related quality of life, and self-reported knee function. Using generalized estimating equations, we evaluated the relationships between the explanatory variables and the primary outcome at each timepoint.
Data were analyzed for 88 participants with a median age of 27 years (15-40 years). Soccer was the most frequently reported preinjury sport (n = 22). Forty participants (46%) had returned to their preinjury sport at 12 months after ACL injury. The odds of returning to preinjury sport at 12 months increased with higher self-reported knee function at 6 months (odds ratio [OR], 1.1; 95% CI, 1.0-1.1), and the odds of being returned to the preinjury sport at 12 months doubled for every 1-point increase (1-10 scale) in psychological readiness to return to sport measured at 12 months (OR, 1.9; 95% CI, 1.2-3.2).
Superior self-reported knee function at 6 months and greater psychological readiness to return to sport at 12 months were associated with returning to the preinjury sport 1 year after ACL injury treated without reconstruction.
Consider highlighting the relevance of biopsychosocial factors to returning to preinjury sport after ACL injury when discussing prognosis during shared decision-making.
非手术治疗前交叉韧带（ACL）损伤的预后研究有限，主要集中在物理因素上。我们旨在评估与生物心理社会方法一致的主要患者报告结果之间的关系，并在不重建的情况下，在 ACL 损伤后 12 个月评估 ACL 损伤患者重返受伤前运动的情况。
我们假设生物心理社会因素与 ACL 损伤后 12 个月重返受伤前运动有关。
前瞻性单队列研究。
2 级。
从瑞典的医疗诊所招募 ACL 损伤且在受伤后第一年未进行重建的患者，并在受伤后 3、6 和 12 个月进行随访。12 个月时重返受伤前运动是主要结局。解释变量为心理准备重返运动、膝关节相关生活质量和自我报告的膝关节功能。使用广义估计方程，我们在每个时间点评估解释变量与主要结局之间的关系。
对 88 名中位年龄为 27 岁（15-40 岁）的参与者进行了数据分析。足球是最常报告的受伤前运动（n=22）。40 名参与者（46%）在 ACL 损伤后 12 个月时已重返受伤前运动。6 个月时自我报告的膝关节功能越高（比值比[OR]，1.1；95%CI，1.0-1.1），12 个月时心理准备重返运动的评分每增加 1 分（1-10 分），12 个月时重返受伤前运动的几率增加一倍（OR，1.9；95%CI，1.2-3.2）。
6 个月时自我报告的膝关节功能更好，12 个月时心理准备重返运动的程度更高，与 ACL 损伤后 1 年不重建而重返受伤前运动有关。
在进行预后讨论时，考虑强调生物心理社会因素对 ACL 损伤后重返受伤前运动的重要性。
