Abuljadail Salahulddin, Albotuaiba Azzam O, Almarri Ali S, Alhamam Abdullah K, Almulhim Abdulmohsen K
Department of Orthopaedic Surgery, King Faisal University, Al Ahsa, SAU.
College of Medicine, King Faisal University, Al Ahsa, SAU.
Cureus. 2025 Apr 25;17(4):e82965. doi: 10.7759/cureus.82965. eCollection 2025 Apr.
Introduction The anterior cruciate ligament (ACL) is essential for knee stability, and its injury significantly impacts athletic performance. Anterior cruciate ligament reconstruction (ACLR) is the standard treatment for active individuals, yet many fail to return to sport (RTS) due to factors like pain and kinesiophobia. This study explores these barriers in the Saudi Arabian population. Methodology This is a cross-sectional study using an online questionnaire targeting ACLR patients across five Saudi hospitals between 2017 and 2023. Tools included are the International Knee Documentation Committee's (IKDC) scale and the Tampa Scale for Kinesiophobia (TSK-11) score. Data was analyzed using IBM SPSS Statistics software, version 29.0.0 (IBM Corp., Armonk, NY). Results Our study included 84 participants undergoing ACL reconstruction. Most were aged between 18 and 25 years (n=35, 41.7%), male (n=75, 89.3%), and employed (n=65, 77.4%). Only 44.0% (n=37) returned to their pre-injury level of sport. Moderate fear of re-injury was common (n=67, 79.8%), and fear significantly correlated with lower IKDC scores (r = -0.410, p < 0.001). Participants with minimal fear had the highest IKDC score (81.01 ± 9.47, p < 0.001). Functional limitation was significantly associated with RTS (p < 0.001); none with moderate/severe limitations returned. Lower pain scores (1.77 vs. 4.35, p = 0.005), lower TSK-11 scores (15.77 vs. 22.90, p < 0.001), and higher knee function (81.01 vs. 63.02, p < 0.001) were significantly linked to RTS. Height > 180 cm was also significantly associated with RTS (p = 0.011). Conclusion Our findings show that returning to sport after ACLR is strongly influenced by functional ability, pain severity, and fear of re-injury. Psychological readiness, particularly kinesiophobia, plays a critical role. Addressing both physical limitations and mental barriers is essential to improve RTS outcomes in post-ACLR patients.
引言 前交叉韧带（ACL）对膝关节稳定性至关重要，其损伤会显著影响运动表现。前交叉韧带重建术（ACLR）是活跃人群的标准治疗方法，但由于疼痛和运动恐惧等因素，许多人未能恢复运动（RTS）。本研究探讨了沙特阿拉伯人群中的这些障碍。
方法 这是一项横断面研究，使用在线问卷针对2017年至2023年期间沙特五家医院的ACL重建患者。所使用的工具包括国际膝关节文献委员会（IKDC）量表和坦帕运动恐惧量表（TSK-11）得分。数据使用IBM SPSS Statistics软件29.0.0版（IBM公司，纽约州阿蒙克）进行分析。
结果 我们的研究纳入了84名接受ACL重建的参与者。大多数人年龄在18至25岁之间（n = 35，41.7%），男性（n = 75，89.3%），且有工作（n = 65，77.4%）。只有44.0%（n = 37）恢复到受伤前的运动水平。对再次受伤的中度恐惧很常见（n = 67，79.8%），且恐惧与较低的IKDC得分显著相关（r = -0.410，p < 0.001）。恐惧最小的参与者IKDC得分最高（81.01 ± 9.47，p < 0.001）。功能受限与恢复运动显著相关（p < 0.001）；中度/重度受限者无人恢复运动。较低的疼痛评分（1.77对4.35，p = 0.005）、较低的TSK-11评分（15.77对22.90，p < 0.001）和较高的膝关节功能（81.01对63.02，p < 0.001）与恢复运动显著相关。身高>180 cm也与恢复运动显著相关（p = 0.011）。
结论 我们的研究结果表明，ACLR后恢复运动受到功能能力、疼痛严重程度和对再次受伤的恐惧的强烈影响。心理准备，尤其是运动恐惧，起着关键作用。解决身体限制和心理障碍对于改善ACLR后患者的恢复运动结果至关重要。
