Up to sixty-six percent of athletes may not return to their preinjury level of sport by 12 months after anterior cruciate ligament (ACL) reconstruction surgery, despite being physically recovered. This has led to questions about what other factors may affect return to sport. The authors’ undertook this study to determine whether psychological factors predicted return to preinjury level of sport by 12 months after ACL reconstruction surgery. The study was made up of recreational and competitive-level athletes seen at a private orthopaedic clinic with an ACL injury. The primary outcome was return to the preinjury level of sports participation. The psychological factors evaluated were psychological readiness to return to sport, fear of reinjury, mood, emotions, sport locus of control,d and recovery expectations. Participants were followed up preoperatively and at 4 and 12 months after the operation. In total, 187 athletes took part. At 12 months, 56 athletes (31%) had returned to their preinjury level of sports participation. Significant independent contributions to returning to the preinjury level by 12 months after surgery were made by psychological readiness to return to sport, fear of reinjury, sport locus of control, and the athlete’s estimate of the number of months it would take to return to sport, as measured preoperatively and at 4 months postoperatively.
The authors’ concluded that psychological responses before surgery and in early recovery were associated with returning to preinjury level of sport at 12 months, indicating that attention to psychological recovery in addition to physical recovery after ACL injury and reconstruction surgery may be called for. They suggested that clinical screening for maladaptive psychological responses in athletes before and soon after surgery may help clinicians identify athletes at risk of not returning to their preinjury level of sport by 12 months.