Association of anxiety and depression history with Arthrofibrosis following primary anterior cruciate ligament reconstruction

Aim: <br/>To (1) identify patient characteristics and peri-operative variables associated with arthrofibrosis (AF) following anterior cruciate ligament reconstruction (ACLR) and (2) evaluate outcomes following arthroscopic intervention. <br/><br/>Design: <br/>Retrospective cohort study <br/><br/>Methods: <br/>A 10-year, single-surgeon dataset of 50 patients who developed AF following primary ACLR was analysed. Variables included demographics, sporting level, surgical factors, clinical presentation (including anxiety/depression status), and patient-reported outcome measures (PROMs) assessed pre- and post-arthroscopy. <br/><br/>Results: <br/>Among 1491 patients, 50 (3.5%) required arthroscopy for AF following ACLR. The AF cohort had a mean age of 31 years (52% male), with mean BMI of 25.9. Revision arthroscopy occurred at mean 1.2 years post-ACLR. Primary symptoms included extension deficit (52%), catching sensation (38%), and pain (32%). Most procedures (90%) utilized hamstring autograft with tightrope fixation (70%). Concomitant procedures included meniscal repair (58%) and lateral extra-articular tenodesis (24%). Patients primarily participated in recreational running (32%) or national elite sport (22%), with 38% reporting anxiety/depression history. Post-arthroscopy, Lysholm scores improved by 19.7 points, satisfaction by 30%, and pain decreased by 20%. <br/><br/>Conclusion: <br/>Pre-ACLR anxiety and depression prevalence in this cohort exceeded national <br/>averages, suggesting a potential risk factor for AF development following ACLR. <br/>Arthroscopic intervention demonstrated significant improvements in clinical <br/>presentation and PROMs.