PSYCHOLOGICAL READINESS AFTER REVISION ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A ROAR STUDY

Revision ACL reconstruction (ACLR) has demonstrated worse functional outcomes and higher reinjury rates in young patients. Psychological associations with revision surgery have not previously been evaluated. The purpose of this study is to investigate levels of psychological readiness and psychological stress in young patients after revision ACLR. Patients, ages 10–35, were enrolled who underwent revision ACLR at one center by one of six surgeons. Psychological readiness and psychological stress was assessed 6-months post-operatively with the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and PROMIS-Psychological Stress Experiences (PROMIS-PSE), respectively. The International Knee Documentation Committee (IKDC/Pedi-IKDC), and Hospital for Special Surgery Pediatric Functional Activity Scale (HSS Pedi-FABS) were also collected. Patient reported outcomes of revision ACLR patients were compared to a cohort of primary ACLR patients. Propensity score matching 3:1 was performed for age, sex, and graft type. Matching resulted in 81 ACLR patients (57 primary and 24 revision). Mean age in the revision group was 18.6 ± 3.2 (66.7% female). The most common graft type in both the primary and revision group was BTB (65% and 67%, respectively) (Table 1). Mild negative correlation was detected between IKDC and PROMIS PSE (r=−0.31; 95% CI=−0.49, −0.10; p=0.005) and a moderate positive correlation was detected between IKDC and ACL-RSI scores (r=0.56; 95% CI=0.39, 0.70; p This study is the first to date to examine psychological readiness to return to sport in young patients after revision ACLR. At 6-months post-surgery, revision ACLR patients had lower psychological readiness scores, inferior knee functional outcomes scores, and delayed return to sport clearance. Greater attention to the psychological aspects of recovery in the revision ACLR setting may be important to help optimize post-operative care and outcomes. For any figures or tables, please contact the authors directly.